Minimally invasive surgery has the potential for minimizing surgical trauma, pain, and recovery in many surgical and orthopedic procedures. This article discusses minimally invasive hip arthroplasty through a two-incision technique; one incision is for the acetabular component, the other is for the femoral component. Unique instruments aid in this technique and fluoroscopy ensures the proper starting points for the incisions and accurate component position and alignment. In the first 100 cases at Rush-Presbyterian-St. Luke's Medical Center, there was one complication 1%; one proximal femoral fracture. There have been no dislocations, no re-operations, and no other complications. Since an outpatient protocol was initiated, 85% of patients have had the procedure as an outpatient. Despite this, there have been no readmissions for any reason and no complications after discharge.