Symptomatic Paget disease about the hip may involve the pelvis or femur or both. Pain usually related to weight-bearing can occur and is associated with medial or concentric joint space narrowing. Surgery may be required for relief of symptoms, especially when arthrokatadysis is present. Total hip arthroplasty utilizing methylmethacrylate has been satisfactory in relieving pain and improving motion. Subtrochanteric and, less frequently, femoral neck fractures occasionally complicate Paget disease of the hip and require surgical treatment with internal fixation. Continuous pain and a mass, especially if associated with symptoms simulating those of a lumbar disk, in a patient with Paget disease about the hip should draw attention to the likelihood of malignant change.