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Introduction: A well-fixed cement–bone interface is a crucial factor for acetabular and femoral components in cemented total hip arthroplasty (THA). The aim of the present study was to evaluate the middle-term clinical and radiological results of fixing the acetabular component with an interface bioactive bone cement (IBBC) technique in primary cemented THA. Materials and methods: We undertook a retrospective review was undertaken of 193 primary cemented THAs in 174 patients using acetabular components cemented with an IBBC technique and followed for a minimum of 5 years (mean 8.3 years; range 5–17 years). Baseline data, clinical and radiological outcomes were evaluated. Results: Japanese Orthopedic Association hip score and modified Harris hip scores demonstrated significant clinical improvement in all patients (p < 0.001). Radiolucent lines were detected in 15 hips (7.8%) at the first year and 24 hips (12.4%) at the final post-operative follow-up. The Kaplan–Meier survivorship with radiographic loosening as the end point was 97.8% [95% confidence interval (CI) 95.2–100]. With revision of the acetabular component for aseptic loosening as the end point, component survival was 99.0% (95% CI 97.5–100). With revision of the acetabular component for any reason as the end point, component survival was 97.0% (95% CI 93.9–100). Conclusions: Clinical and radiological results of the acetabular component with the IBBC technique in primary cemented THA were excellent. [ABSTRACT FROM AUTHOR]