To evaluate the clinical efficacy of mechanical thromboprophylaxis after elective hip surgery, we reviewed 3016 patients who underwent hip surgery at 5 centers. Primary total hip arthroplasty (THA), revision THA, and pelvic or femoral osteotomies were performed in 2648, 298, and 70 patients, respectively. Epidural anesthesia, intraoperative calf bandage, early mobilization, and intermittent pneumatic compression postoperatively with additional use of elastic stockings were the basic regimen for thromboprophylaxis. Postoperatively, no cases of fatal pulmonary embolism (PE) were encountered. One symptomatic PE and 4 symptomatic deep vein thrombosis cases were identified, all of which were successfully treated using heparin and warfarin. By 6 months, no deaths had occurred. We conclude that mechanical thromboprophylaxis without anticoagulant drugs is safe and effective for elective hip surgeries in our patient population.