[Objective] To introduce the surgical technique and preliminary clinical results of total hip arthroplasty (THA) without femo- ral shortening osteotomy for end-stage arthrosis complicated with femoral head and neck shortening deformity. [Methods] A total of 19 pa- tients received THA for end-stage hip arthrosis complicated with femoral head and neck constriction deformity. A posterolateral approach was used to expose the hip complicated with severe deformity. Identifying the location of the true acetabulum, the poorly developed acetabu- lum was reconstructed with autologous femoral head, reamed and then implanted with the acetabular components in proper position. After contracted soft tissues around the joint were released successively, the proximal femur was prepared and inserted with femoral stem in proper size. After trial, the femoral head component in suitable length was installed, and the joint was reduced with proper stability and motion. [Results] All the 19 patients had THA performed successfully with good initial stability of acetabulum and femoral components without serious complications, and followed up for 6 to 36 months. Six months after the operation, the Harris score was of (94.5±4.7) , while the clinical out- come was graded as excellent in 15 cases and good in 4 cases, with an excellent and good rate of 100%. In term of imaging, all the patients maintained the hip center of rotation in anatomic position, and had prosthesis in proper position, got obvious bone ingrowth of the prosthesis 3 months after surgery, without dislocation, stem displacement or fracture during follow- up. [Conclusion] Total hip arthroplasty without femoral shortening osteotomy is feasible technique for treatment of end-stage arthrosis complicated with femoral head and neck shortening deformity, does achieve satisfactory short-term clinical outcome.