OBJECTIVE The purpose of this study was to assess the clinical and radiographic results of a total hip arthroplasty with the double tapered Mallory-Head system. METHODS The clinical and radiographic results of a consecutive series of 81 total hip replacements in 75 patients were reviewed 10-15 years (average 11.4 years) postoperatively. The patients' underlying conditions were avascular necrosis in 46 hips (57 %), osteoarthritis in 12 hips (15 %), RA in nine hips (11 %), and others. Clinical results were evaluated based on the modified Harris hip score and modified Merle d'Aubigné-Postel score. A radiographic analysis was performed. RESULTS The average modified Harris hip score improved from a preoperative score of 56 points to a postoperative 92 points. The average modified Merle d'Aubigné-Postel score was 15 points at the latest follow up, and 55 hips (68 %) were classified as the clinical grades of excellent or good results. One acetabular component was revised because of loosening, and one was revised for recurrent dislocation. CONCLUSIONS The clinical and radiological evaluations of the total hip replacements using the Mallory-Head system showed good results.