This preliminary report deals with the early results obtained from a new conservative hip arthroplasty--the Wagner resurfacing total hip arthroplasty in which the acetabulum is replaced with a high-density polyethylene cup and the femoral head resurfaced with a metallic cup. Between February 1977 and September 1978, 51 patients, ranging in age from 12 to 70 years, underwent this operation. They had a variety of hip diseases. All patients were assessed prospectively by the Harris hip rating method. The results of operation were excellent. All patients but one had complete or marked relief of pain. To date there have only been two failures. With this procedure the considerable problem associated with the conventional hip arthroplasty, that of stem loosening, is avoided. It is possible to salvage a failed Wagner resurfacing operation by hip arthrodesis or by conventional total hip arthroplasty. While it is still too early to advocate its universal acceptance, the Wagner resurfacing total hip arthroplasty is expected to be widely adopted and used with success.