Avascular necrosis (AVN) of the femoral head is one of the common causes of painful hip in a young adult. Bilateral presentation is frequently seen and males are more commonly affected. Total hip replacement (THR) is one of the most successful surgical procedures for AVN. THR is a time tested surgery giving good outcome in terms of relieving pain, restoring function & improving quality of life in patients of AVN. The purpose of the study was to analyse the outcome of bilateral THR & comparing the outcome of one stage THR with Two stage THR. In this study, 40 patients with AVN of bilateral femoral head who were presented in the Department of Orthopaedics, Hamidia Hospital, Bhopal from April 2016 to April 2020 who fulfilled the inclusion criteria were included in the study. THR of all the patients was done on elective basis by senior surgeons of the department. All patients were followed up clinically and radiologically for a period of 6 months after the surgery. Any complications if present were also noted. This study concludes that in patients of AVN of bilateral femoral head, THR gives excellent functional outcome with early walking & early return to work. As compared to Two stage bilateral THR, One stage bilateral THR has advantage of less blood loss, less need of parenteral analgesics & antibiotics & less hospital stay. However, there is no significant advantage in terms of functional outcome, walking capability & return to work.