Total hip arthroplasty (THA) with ceramic-on-ceramic bearings and an uncemented design is considered an effective treatment of developmental dysplasia of the hip, especially for young, active patients. The new generation of hip resurfacing with large femoral heads offers more stability, better range of motion (ROM), and more bone preservation than conventional THA. Twenty-one consecutive patients (26 hips) with osteoarthritis secondary to developmental dysplasia of the hip underwent metal-on-metal hip resurfacing. Average patient age at the time of surgery was 46.5 years (range, 37-59 years). Six patients (28.6%) were men and 15 (71.4%) were women. During the same period, another 21 patients (26 hips) with developmental dysplasia of the hip secondary to osteoarthritis were treated with ceramic-on-ceramic THA. Average patient age at the time of surgery was 48.2 years (range, 38-64 years). At follow-up, no complications (eg, dislocation, infection, or symptomatic deep venous thrombosis) occurred in the 2 groups. No significant difference was noted in Harris Hip Score between the 2 groups, but the average ROM of the hip resurfacing group was significantly better than the THA group (P<.05). All patients reported significant pain relief on their operated hips, with the postoperative visual analog scale scores <2. No signs of early loosening were observed on radiographs. The short-term results of the metal-on-metal hip resurfacing have been encouraging in the treatment of developmental dysplasia of the hip, with better ROM recovery than conventional THA.