The purpose of this report is to present the clinical and radiological findings of a young patient affected by proximal femoral and acetabular osteochondroma. This benign primary tumor of the long bones occurs in childhood and is localized in the proximal femur only with low incidence. As far as we know, there are only 30 other cases in the literature of an osteochondroma involving the entire hip joint. Out of these 30, only 17 patients were treated with lesion excision and joint replacement. However this is the first patient treated with a short stem total hip replacement. The innovative short stems allow the bone saving of the proximal femur, a necessary condition to have a good bone stock in the event of a future prosthetic revision in a highly demanding young patient. Preoperative planning and specific rehabilitation are mandatory to achieve good outcomes.