Disturbance of lung function during hip arthroplasty surgery is well recognised and, until now, only reported secondary to femoral instrumentation. We present a case report of per-operative acute pulmonary embolism that followed the insertion of an intereference fit acetabular component during hip resurfacing arthroplasty. A subsequent prospective study of per-operative lung function revealed that 9 out of 10 patients experienced an increase in pulmonary shunt value of up to 30% following socket insertion. The changes in shunt values were significant (p=0.009). We have highlighted for the first time the significant physiological disturbances that occur upon insertion of solid interference fit acetabular components, which although apparently transient, may prove life threatening.