Cemented total hip arthroplasty was first introduced by Sir John Charnley in 1961 and it has become one of the principal fixation techniques for fixation of an implant. The surgical technique has since been modified and this has resulted in improved longevity and reliability. The clinical success of the cemented technique has varied in literature, and this has been reported as 30~40% failure to 2% failure for 14 years of follow up using the 2nd generation cement technique. Currently, the successful clinical results can be contributed to the better developed design of the femoral stem and the advancement of the 3rd and 4th generation cement fixation techniques. As society gains more elderly people, for the older patients who have osteoporosis, a wide and thin femur would be the best indication for cement fixation in order to achieve early stability and better clinical results. It is imperative to learn and practice performing the exact cement fixation technique to achieve the best clinical results.