The Birmingham hip resurfacing (BHR) arthroplasty has shown good medium-term results in the centres that have been involved in its development. A retrospective cohort study analyzing the clinical and functional outcome of 297 metal-on-metal BHR arthroplasties at an independent hospital was performed. At medium-term follow-up, 4 patients had died, 8 patients were lost to follow-up (2.7%), and 6 hips (2.0%) had undergone revision surgery. The mean Harris hip score (HHS) increased from 56.2 preoperatively to 96.4 at follow-up. The BHR resulted in a very high postoperative HHS and enabled active patients to return to work and engage in sports. With an acceptable revision rate of 2.0% and an overall survival rate of 97.1% at five years, our results were similar to those of the designer centers.