The global prevalence of obesity has doubled since 1980, affecting nearly one-third of the world's population [1]. This widespread pandemic poses a significant public health threat, given that obesity affects nearly all physiological functions of the body, it has been identified as an adverse prognostic factor in various orthopedic interventions [[2], [3], [4], [5]].

The prevalence of osteoarthritis (OA) in the obese population is increasing, with individuals experiencing hip osteoarthritis on average 5.7–7.0 years earlier than their normal-weight counterparts[[6], [7], [8], [9], [10]]. As a result, over the last decade, the proportion of obese individuals undergoing total hip arthroplasty (THA) in the United States has risen from 42 % to 49 % [11].

Hip resurfacing (HR) has emerged as an alternative for obese male patients requiring arthroplasty. HR offers potential advantages; including lower dislocation rates, restoration of native biomechanics, femoral bone preservation, and lower wear rates compared to conventional THA. [[12], [13], [14], [15], [16]]. Considering these potential advantages, particularly for the more active obese population, HR could be a viable alternative. However, there is a paucity in existing literature regarding how obesity influences the outcomes of modern HR [17,18].

The purpose of this study was to conduct a short-term analysis of patients with obesity who underwent HR for hip OA. We also aimed to compare their outcomes with a benchmark control group of non-obese patients. Our hypothesis was that patients with obesity undergoing HR would experience a comparable improvement in PROs; however, they may also experience a higher rate of complications.