The long-term survival of 270 Wagner resurfacing hip arthroplasties was determined. Two patients were lost to follow-up. Eleven hips remained unrevised at 15 to 22 years. Survival at 5, 10, and 16 years was 74%, 35%, and 17%, respectively. Survival in patients older than 55 years was better after 5 years than that for patients 55 years or younger (P = .0067). Femoral neck fracture occurred in 2% of the total cohort. Femoral component failure was an early and midterm complication. Acetabular component loosening was the most common reason for revision. The proportion of cases revised for acetabular component failure increased with time. These long-term data in this large series provide important historical results against which the relative benefits of contemporary designs may be evaluated.