A complete 10- to 12-year follow-up of an uncemented total hip arthroplasty (THA) was performed regarding survival, clinical outcome, polyethylene wear and influencing factors on wear. Seventy-two patients (75 Mallory Head uncemented THA) with primary osteoarthritis operated on in 1999 or 2000 were included in the survival study. Mean age at the time of operation was 57.9 years (range 37–70). The survival rate after 11.9 years was 96% (95% CI 0.89–1.01). In three cases the acetabular component was revised because of extensive polyethylene wear. Fifty-four patients with 57 THAs were available for clinical and radiological analysis. At a mean follow-up time of 10.7 years (range 10–12) the clinical outcome can be considered comparable to other uncemented THA. Mean polyethylene wear was 1.8 mm (range 0.4–3.8) with an annual wear rate of 0.15 mm/y. There was a significant correlation between polyethylene wear and inclination of the cup as well as male gender.