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We report outcomes on 120 Birmingham Hip Resurfacings (BHRs) (mean age 50 years) at a minimum of ten-years follow-up. Cases were performed by one surgeon and included his learning curve. Six hips were revised, with no revisions for infection, dislocation, or adverse reaction to metal debris. Ten-year survival was 94.2% (95% confidence interval (CI) 88.8%–98.7%) for all revisions and 96.1% (95% CI 91.5%–99.8%) for revisions for aseptic loosening. Gender (P = 0.463) and head size (P = 0.114) did not affect revision risk. Mean post-operative Harris hip score was 84.0. Contrary to previous independent reports, good outcomes into the second decade were achieved with the BHR in both men and women. Longer term follow-up will confirm whether these promising outcomes in women continue.