With the maturity and development of artificial joint replacement technology, the level of artificial hip and knee joint replacement in our orthopedic department has been improving, and we can carry out some difficult joint replacement surgery or bilateral simultaneous replacement surgery. Artificial hip arthroplasty is the last resort for treating hip joint lesions such as femoral head necrosis, osteoarthritis, rheumatoid arthritis and hip ankylosis caused by ankylosing spondylitis. Some of these patients have bilateral disease, long disease duration, and the effect of conservative treatment is not obvious, resulting in bilateral hip pain and impaired movement, which gradually causes hip ankylosis, leading to the patient’s inability to take care of himself and loss of working ability, seriously affecting the patient’s quality of life and causing serious blow to the patient’s psychology and family. Because of this, although the patient is young, in order to improve his quality of life, he has to undergo artificial hip replacement. In order to make patients recover as soon as possible and return to work as soon as possible, bilateral hip replacements can be performed on these patients at the same time. Bilateral hip replacement can shorten the hospitalization time and reduce the medical cost, and more importantly, bilateral surgery can facilitate rehabilitation, because these patients have hip deformation and the lower extremities are not equal in length after one surgery, and the non-operated side is still painful and cannot move, which seriously affects the patient’s ability to get out of bed and rehabilitation training. Similarly, both knees can be replaced at the same time, and this will not be repeated. Nevertheless, not every patient with bilateral hip pathology can undergo simultaneous bilateral hip replacement surgery. The choice of simultaneous hip replacement must be based on the patient’s age, general condition, the presence of comorbidities and intraoperative conditions, and in particular on the need to consult with the anesthesiologist during surgery, otherwise the benefits will not be worth the losses. Remember that surgical safety is always the first priority and saving money and time is secondary.