Although hip osteoarthritis usually shows a slow progression, a rapidly destructive osteoarthritis is observed in approximately 10% of patients. We aimed to present a case with rapidly destructive osteoarthritis in bilateral hip joints. A 78-year-old male patient was admitted due to pain in hip joints. On examination, hip movements were minimally painful and limited. The patient was able to walk independently with a cane. When he re-applied six months later, hip movements were severely limited and painful. In plain radiographs, while a slight narrowing in hip joint space, sclerosis and minimal osteophyte had been observed at the first observation, extreme narrowing, subluxation, flattening of femoral head, increased sclerosis, resorption in femoral head and acetabulum were detected six months later. We consider that hip osteoarthritis in elderly people should be monitored at frequent intervals to assess both clinic and radiological progression.