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Outcome data beyond 11 years of follow-up is not available for the third-generation Zweymuller femoral stem in combination with a polyethylene bearing. We report ten to 15-year results with this total hip arthroplasty (THA) combination in a young population. A retrospective, observational, non-randomised, single-centre, clinical observational study was conducted in which 311 primary THAs were performed in 276 patients between 1996 and 2000 using a third-generation Zweymuller stem. The mean age of the patients at operation was 47.4 years (range 18–77 years). Stem survival for any reason was 93.5 % after ten years and 89.6 % after 13 years, and the probability of aseptic stem loosening was 98.7 % at both ten and 13 years. The occurrence of femoral radiolucent lines was low, at just 17.2 %. Minor femoral osteolysis was identified in 30 % of patients and was attributed to polyethylene liner wear. Clinical and patient satisfaction outcomes were in line with previous investigations, and the rate of adverse events was low. The third-generation Zweymuller stem shows good radiographic and clinical results and good longevity, including in the younger osteoarthritic patient. The use of low-wear bearings may further reduce the rate of osteolysis and wear-related revision in young and active patients.