Introduction: rapidly destructive hip arthropathy is a recognised condition. Some authors considered it as a subset of osteoarthritis but none has identiþed the aetiology, pathogenesis or risk factors. Patients and methods: Authors present 14 cases of an extreme subset of rapidly destructive hip arthropathy. The radiological deterioration occurred dramatically over a short period ranging from 2 weeks up to few months. Loss of femoral head ranged from 25% up to 100% of the head volume. Acetabulum was damaged in all cases and femoral neck was partially lost in 9 cases (up to 75%). 4 cases were associated with dislocation. Age ranges from 53 to 85, female to male ratio (8 to 6), 2 patients had bilateral disease. Results: Clinical and radiological features were similar to those of neuropathic joint, infection, neoplasia, or avascular necrosis. However these conditions were excluded by further investigations; laboratory, imaging, surgical exploration and histopathology. All patients underwent hip arthroplasty. Some common (at risk) features included elderly patients, long history of receiving strong NSAIDs, radiologically atrophic and predominantly lateral disease. Conclusion: It appears that this condition represents a new entity but authors were not able to identify the aetiology. Awareness of this condition is important and at risk patients should be closely monitored.