Background:Femoral head size and surgical approach might affect the revision rate for dislocation and for any other reason after total hip arthroplasty (THA). We penetrated this question based on registry data with up to 9-year follow-up.Methods:269,280 primary THAs documented in the Dutch Arthroplasty Registry (LROI) between 2007 and 2019 were included. Revision rates were calculated by competing risk analyses. Multivariable Cox proportional hazard regression ratios (HR) were used for comparison.Results:Revisions for dislocation were rare. They were more frequent after posterolateral (1.4% [95% CI, 1.3–1.5]), compared to straight lateral (0.6% [95% CI, 0.5–0.7]), anterolateral (0.6% [95% CI, 0.5–0.7]) and anterior (0.4% [95% CI, 0.3–0.5]) approach. Larger femoral head size decreased the dislocation revision risk: 1.4% [95% CI, 1.3–1.5) for 22–28-mm heads; 0.9% (95% CI, 0.8–1.0) for 32-mm heads; 0.6% (95% CI, 0.6–0.7) for 36-mm heads. For the anterior approach, the HR for both revision for dislocation (0.3, ...