Abstract: Joint replacement surgery is emerging surgical procedure in developing countries .In Nigeria, joint replacement is becoming very popular in some of the tertiary hospitals, but it is still being practised by few arthroplasty Surgeons because of paucity of instrumentation and patients’ financial constraints. Osteoarthritis is the commonest indication for total joint replacement in Nigeria, however, many sufferers of the disease are unaware of joint replacement while others are not willing to have joint replacement done because of many reasons ranging from financial constraints to fear of complications such as any form of disability from the procedure. Objectives: to study of the awareness and acceptance of total joint replacement surgery among patients suffering from severe osteoarthritis of the hip and knee joints. Patients and methods: A five year prospective study of 81 patients (from January 2012 to December 2017) who presented in the outpatient consultation clinic of the department of Orthopaedics and traumatology in University of Calabar Teaching Hospital, South-south, Nigeria. A well structured questionnaire was administered to the patient requiring information about their biodata, educational level, the joint affected by osteoarthritis, the level of pain using numeric rating scale(NRS), their knowledge of total joint replacement ,their willingness to accept total joint replacement, reasons for not accepting the surgery, Xray findings and radiological classification of the osteoarthritis using Kellgren and Lawrence classification .Informed consent was obtained from the patient and ethical approval obtained from the institution’s ethical committee. Statistical analysis was done using Statistical Package for Social Sciences software version 20 for windows (SPSS 22 Trademark of IBM Corporation). P-value of 0.05 was .....................