Total hip replacement is very effective procedure to relieve the pain and disability in young active patients. This study reports our initial experience of THR in young patients below 30 years old regarding the functional outcome and complications. Twenty-eight patients (30 hips) were included in the study their age ranged between 18-26 years old. All were Cairo University students. The follow up ranged between (6-24) months. The clinical evaluation of the cases in the study depends on Harris hip score. This study showed the excellent results of cementless alumina ceramic on ceramic THR in young active patients due to its superior wear character. The future of ceramic on ceramic THR appears to be extremely promising in young active patients.