Previous reports indicate that elderly patients suffer more complications than younger patients undergoing total hip arthroplasty (THR). We reviewed 60 consecutive elderly patients undergoing THR. Statistical comparisons were made with a control group of patients. The average age was 86.6 (range 85-92) years. Pre-operative D'Aubigne-Postel Score averaged 8.4 (range 1-14) points, post-operative D'Aubigne-Postel Score averaged 13.1 (range 9-18) points. Compared to the control group, elderly patients had an increased intra-operative blood loss, increased blood transfusion rates, (p=0.0005) and a longer hospital stay (p = 0.0002). Comparing D'Aubigne-Postel scores, there was no significant difference between the two groups (p<0.001). We conclude that THR in elderly patients is a safe procedure and leads to functional improvements similar to those seen in younger counterparts.