Resurfacing arthroplasty (n = 60) was as efficacious as total hip arthroplasty (n = 66) at 12 months after surgery for patients with severe hip osteoarthritis (OA) in this single centre, blinded, randomized controlled trial. Intention-to-treat analysis found no inter-group difference in hip function, based on Oxford and Harris hip scores. Complication rates were also similar in the two groups, but wound complications and thromboembolic events were more common in the total arthroplasty and resurfacing groups, respectively. Longer term data are required.