The article presents the general concept of minimally invasive surgery, including theoretical benefits and risks. The indications, contraindications, technical requirements and necessary precautions are discussed. An overview of different surgical approaches is presented together with a detailed description of the surgical technique of minimally invasive cementless total hip replacement that is used at the Department of Orthopedics and Traumatology of Locomotor System, Medical University of Warsaw. Techniques for enhancing the precision of placement of prosthetic elements and leg length equalization used in clinical practice are also presented.