Aims: To study clinicoradiological correlation with metal levels in patients with metal-on-metal hip resurfacings. Methods: Serum levels of Cobalt (Co) and Chromium (Cr) in 18 patients undergoing metal-on-metal resurfacing were measured preoperatively and at 6, 12, 24 and 36 months postoperatively. Implants were made of cast Co-Cr alloy. Cr analysis was by graphite furnace atomic absorption spectrometry (ETA-AAS) & Co analysis by inductively coupled plasma mass spectrometry (ICP-MS). Results: Patientsñ mean age: 51.6 years. Average preoperative levels of Cr and Co: 10.5 nmol/l & 7 nmol/l respectively. All patients showed increase in serum cobalt and chromium. Maximum Cr levels increased by 20 fold (range 5–106) and Co by 30 fold (range 3–91) after 12 months in 71% cases. In 69% cases, chromium levels were higher than cobalt levels. Downward trend was noted in 4 cases after 2 years postoperatively. Bilateral cases were similar to unilateral cases. Postoperative HHS was 77.2 (range 50.2–87.6). One dislocated hip had 171-fold increase of Cr and Co by 107 fold. No radiological abnormalities were noted. Conclusions: Increase in serum levels of both cobalt and chromium is due to ñself polishing phenomenonñ correlating with an increase of patientñs physical activity. This may stabilise or show a downward trend after 2 years. The patients with very high levels tended to be relatively young compared to others. Level of activity and age may determine amount of metal release from implanties.