We reviewed the clinical and radiological outcome at a minimum of five years of 140 consecutive metal-on-metal hip resurfacing (HR) arthroplasties in 132 patients. The mean follow-up was 73 months (62 to 105). Revision of either component was defined as failure. The average Harris hip score (HHS) was 58.6 (25 to 88) preoperatively and 94.4 (60 to 100) at the latest follow-up (p<0.0005). Average University of California Los Angeles (UCLA) activity score was 3.1 (1 to 9) pre-operatively and 6.7 (2 to 10) post-operatively (p<0.0005). The survival after 6 years was 97.8% overall and 98.5% (excluding a post traumatic femoral neck fracture). These good medium-term results suggest that HR is an effective procedure in young and active patients.