Legg-Calve-Perthes disease is characterized by osteonecrosis of the femoral head during childhood. Outcomes of total hip arthroplasty (THA) for these patients are less satisfactory than for those with primary osteoarthritis, often complicated by young patient age, multi-planar deformities and previous childhood surgery. To our knowledge no one has reported the long-term outcomes of cementless custom-made THA in patients with Legg-Calve-Perthes disease. We reviewed 15 THAs with an average follow-up of ten years. Survivorship rates of the femoral and acetabular components were 100% and 79% respectively. Mean Harris Hip Scores improved from 41 preoperatively to 80 at final follow-up. With excellent functional outcome, custom-made cementless prostheses should be considered as a treatment option for osteoarthritis secondary to Legg-Calve-Perthes disease in the presence of abnormal proximal femoral and acetabular anatomy.