Background: Hip hemiarthroplasty, a common surgical intervention for femoral neck fractures and other hip pathologies, may sometimes lead to aseptic failure due to various complications. When such failure occurs, conversion to total hip replacement (THR) becomes necessary, posing unique surgical challenges. This study aimed to evaluate early results of Conversion of 30 cases of aseptic failed hip hemiarthroplasty (bipolar or unipolar) to total hip replacement. Methods: This study is a prospective analysis of 30 patients who sought treatment at Benha University Hospital, Nasser Institute Hospital, and El Kasr Elainy Hospital, presenting with failed hip hemiarthroplasty. These patients were followed up for 12 months as part of a short-term study. Results: The study included 30 patients, primarily male (73.3%), with a mean age of 63 ± 5 years. Acetabular erosion was the most common indication (43.3%). Intraoperative complications were minimal, with most patients experiencing no issues (93.3%). Postoperative complications included superficial infection (10%) and other less frequent complications. At one year, most patients had excellent Harris Hip Scores (80%). Conclusions: Transforming symptomatic hemiarthroplasty into THA is a secure alternative that yields favorable functional outcomes, albeit with slightly increased incidences of both intraoperative and postoperative complications.