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This study aimed to measure femoral head perfusion during hip resurfacing arthroplasty through a trochanter-sparing modified direct lateral approach. High-power laser Doppler probes were inserted into the femoral heads of 26 patients (26 hips, age range 35-70 years). Changes in blood flow were recorded (1) pre-capsulectomy (reference), (2) post-capsulectomy, and (3) following femoral head dislocation and reduction. There were no statistically significant changes in perfusion amplitudes post-capsulectomy and following femoral head dislocation and reduction (mean -10%, P  = .134 and +27%, P  = .166, respectively). Prolonged dislocation with the hip maximally flexed and externally rotated resulted in significantly decreased perfusion (mean -28%, P  = .002). This study provides in vivo evidence that surgical hip dislocation is feasible using a modified direct lateral approach.