Over the past 10–15 years, many aspects of total hip arthroplasty (THA) have changed. First and foremost, the patients themselves have changed. Since 1990, the age group that has demonstrated the greatest increase in THA was patients between the ages of 45 and 64. As younger, healthier patients are having surgery, a greater emphasis is being placed on postoperative function, activity, and exercise. The rationale for increased postoperative activity is 2-fold: the obvious cardiovascular benefits of exercise and greater patient desire to return to recreational sporting activities. The purpose of this review is to discuss how recent changes in surgical technique, implant design, and pre- and postoperative rehabilitation have affected postoperative athletic activity for THA patients. Although these topics have been addressed often in the orthopedic literature, to our knowledge no published articles have summarized this information for a targeted audience of rehabilitation specialists.