The authors reviewed the preoperative and postoperative charts and radiographs of 100 patients who were at least 80 years old when they underwent total hip arthroplasty, Seventy-six of these patients were available for further reexamination and evaluation, The average patient age was 85.2 years old (range, 80-97 years), The average followup period was 59.4 months (range, 26-146 months), The female to male ratio was 4 to 1, Osteoarthritis was the most common diagnosis, Hospital stay ranged from 12 to 39 days, Preoperative Charnley pain and walking scores averaged 5.1 points of a possible 12 points, and postoperative scores averaged 10.6 points. Eighty-eight percent of patients remained community walkers, and 60% used a cane. Four percent of the patients had 1 dislocation, There were no instances of mechanical loosening and no deaths, Subjective satisfaction was high, The level of independent living was maintained in 96% of patients at long-term followup, A satisfactory and cost-effective health outcome can be anticipated after total hip arthroplasty in octogenarian and nonagenarian patients.