The authors studied a series of 330 Total hip replacements with 6 months to 4 years follow-up, in order to define a new trans-trochanteric approach. The procedure, with a two slope trochanterotomy, is a curved posterolateral approach. The shell bone, with attachment of Mm gluteus, M. vastus lateralis and M. piriformis is pushed forward. The other pelvic-trochanteric muscles stay with the femoral shaft. Two revisions (0.6 per cent) had to be performed because a faulty accomplishment of the trochanteric osteotomy. The trochanteric fusion was always achieved. One third of the hips was stable at one month post-op and 95 per cent at 6 months. This approach is a variable of the conventional transtrochanteric approach and it seems to decrease markedly its disadvantages.