Ochronosis is a rare inherited genetic disorder that affects tyrosine and phenylalanine metabolism. It leads to the deposition of dark pigments in connective tissues and articular cartilage, which are rich in collagen. This may lead to severe joint degeneration, known as end-stage arthropathy of the joints. In such cases, arthroplasty can offer significant improvement in function. We present a case of a 52-year-old man who was diagnosed with secondary osteoarthritis in his right hip. During the surgery, ochronosis was unexpectedly discovered. An uncemented total hip arthroplasty was carried out and yielded positive results. Additionally, this particular case exhibited widespread effects on both knees and the dorso-lumbar spine. This case demonstrates that total hip arthroplasty can successfully treat severe ochronotic arthropathy, resulting in functional outcomes comparable to those seen in primary osteoarthritis. However, early diagnosis is crucial. To achieve this, healthcare professionals must be aware of the condition, maintain a high index of suspicion, and conduct a thorough clinical examination.