The concept of a hip resurfacing procedure is not new. Many well-known surgeons, over the last 4 decades, at times advocated the practice of resurfacing the hip, as it seemed intuitively most logi-cal to ‘reshape’ the joint to its native form, instead of performing a hip replacement. However, not all generations of hip resurfacing were successful, for a variety of reasons. The lessons learned from each generation of hip resurfacing improved our understanding of surgical technique, hip biomechanics, and tribology. The knowledge gathered from the past, coupled with advancements in technology and manufacturing, have enabled surgeons to now offer hip resurfacing with various bearings to young arthritic patients.