Background: joint replacement is the first choice for the elderly patients with displaced femoral neck fracture. It has been reported that the revision rate of hemiarthroplasty (HA) is higher and more complicated than that of total hip arthroplasty (THA). Therefore, we report the common causes of HA revision to THA and the follow-up results. Methods: using a retrospective cohort approach, we identified patients with HA revision THA from 2010 to 2020. Relevant clinical data were collected, including intraoperative conditions, preoperative and postoperative range of motion (ROM), VAS score and Harris score. Results: in all the 39 patients included, 59.0% of the patients had acetabular base wear, and 46.2% of the patients had femoral stem problems. 82.1% (32 / 39) of the patients replaced the full set of hip components, and 17.9% (7 / 39) of the patients only replaced the acetabular components. Compared with before revision, the ROM and Harris scores of hip flexion in 39 patients at the last follow-up were significantly increased (P < 0.05) and VAS scores were significantly decreased (P < 0.05). Conclusion: acetabular wear and loosening of femoral stem are the main reasons for HA revision to tha, and the joint function of patients after revision has been significantly improved.