Aims: We wanted to investigate the association between risk factors recorded prospectively before primary hip replacement, and the risk for later revision hip surgery. Methods: During the years 1977–83 The National Health Screening Service in Norway conducted an investigation of risk factors for cardiovascular disease. 56,818 persons born 1925–42 were invited, and 92% participated. We matched these screening data with data from the Norwegian Arthroplasty Register concerning primary and revision hip arthroplasty. Results: We identified 504 men and 834 women who had received a primary total hip replacement after the screening. Of these 75 and 94 were revised during follow-up. Mean age at screening was 49 years; mean age at primary hip replacement was 62 years. Mean age at censoring was 68 years. Men vs women had a relative risk of 1.9 of undergoing hip revision during follow-up (95% CI 1.3–2.8). For each years increase in age at primary hip arthroplasty, the risk of revision surgery during follow-up decreased with 14% for men and 17% for women. Men who at screening had the highest level of physical activity during leisure had 5.5 times the risk of later revision, relative to those with the lowest level of physical activity (95% CI 1.0–31.9). Conclusions: Men have a higher risk for revision hip surgery. There is less risk of revision the older the patient is at primary hip arthroplasty. Men with intense physical activity at middle age are at increased risk of undergoing revision hip surgery before they are 70 years old.