Total hip replacement (THR) is becoming relatively commonplace in the dog. This article describes an unusual case of staged bilateral, cementless THRs in a skeletally immature dog. The decision-making process for this case is reviewed. The article also reviews the indications, complications and prognosis for THR in the dog. The various systems that are commercially available are also briefly described. It is hoped that the reader will have a better understanding of which dogs are candidates for referral for surgery, and that he/she is better prepared to discuss this with owners.