Two hundred fifty cases of F.R. Thompson endoprosthesis replacement without methylmethacrylate in acute femoral neck fractures between 1969 and 1973 were reviewed. Follow-up evaluation was obtained in 94 patients averaging 4.8 years postoperative utilizing the Harris hip questionnaire. None of the patients were personally examined, but each was interviewed and rated for pain, function, and satisfaction with the hip surgery. The average Harris score was 63 points giving 56% overall satisfactory results. Pain relief was satisfactory in 85% of cases. Functional results were 71% fair or better, and 90% were satisfied with the overall results. Mortality at one year postoperative was 23%. Incidence of deep wound infection was 2% and prosthesis dislocation was 1%. Both infection rate and dislocation rate were higher in posterior exposure compared to anterior lateral surgical approach. The lack of methylmethacrylate cement apparently did not delay postoperative ambulation, as 60% of all patients were discharged within 4 weeks of fracture. The indications for methylmethacrylate with the Thompson endoprosthesis is an unanswered question and requires further investigation.