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Purpose: The purpose of this study was to analyze the results for clinical outcome and radiologic assessment of ceramic on ceramic cementless total hip arthroplasty using a 36 mm diameter femoral head. Materials and Methods: This study included a group of 40 patients of 43 cases who underwent ceramic on ceramic cementless total hip arthroplasty using a 36 mm diameter femoral head. The age range of this group was 28 to 82(mean 56); we monitored them over a period of 5.3 years(3-7.5 years). This clinical evaluation process included monitoring the degree of pain, range of motion, and the Harris Hip Score after three years since the surgery was performed. Radiographic evaluation and complication were confirmed as well. Results: The preoperative Harris hip score increased from 43.4(21-57) to 88.1(81-95) after the surgery. The average motion range of hip was 113°flexion, 30° abduction, 24° adduction, 36° external rotation, and 12° internal rotation. Subjective pain was zero or minimal in all cases. Among the complications, dislocation occurred in only one case by a fall from a height and was reduced by closed reduction. There was no occurrence of ceramic fracture, even though infection occurred in one hip. Conclusion: The clinical outcome and radiologic assessment of the ceramic on ceramic cementless total hip arthroplasty using a 36 mm diameter femoral head showed a satisfactory result at three-year follow-up. Longerterm follow up is needed for further assessment. [ABSTRACT FROM AUTHOR]