Periprosthetic joint infection (PJI) remains a significant complication following total hip arthroplasty (THA), with infection rates ranging from 0.5% to 2%. Several strategies have been described for managing the infected THA, and although two-stage exchange remains the standard in North America, the optimal treatment strategy is controversial. One-stage (ie, single-stage) exchange is used predominantly in Europe. Several recent studies have compared one- and two-stage exchanges for chronic PJI when treatment options were determined through an algorithmic approach; one-stage exchange showed equivalent success rates, higher Harris hip scores (HHSs), lower complication rates, and greater patient satisfaction. At our institution, four female patients and one male patient have undergone one-stage exchange for PJI following THA. Mean time to revision was 27.2 days (range, 10 to 62 days). At the time of revision, the average patient age was 73.54 years (range, 64 to 89 years), and mean body mass index was 35.98 kg/m2 (range, 24 to 45.1 kg/m2). Four different infecting organisms were identified, including Enterococcus faecalis, Pseudomonas aeruginosa, Staphylococcus aureus (in two cases), and S epidermidis. All five patients received intravenous antibiotics for 6 weeks, and three patients were prescribed suppression antibiotics (range, 6 weeks to lifetime). The mean postoperative HHS was 88.83 (range, 74.8 to 99.85) at a mean follow-up of 459 days (range, 309 to 733 days). The mean postoperative erythrocyte sedimentation rate and C-reactive protein level were 50.25 mm/hr and 3.0 mg/L, respectively, at a mean follow-up of 92.5 days (range, 6 to 309 days). All five patients had retained their implants at a mean follow-up of 459 days. This video contains a case presentation, footage on the seven-part surgical method that has been successful at our institution, the previously mentioned outcomes on one-stage exchange performed at our institution, and a review of the related literature.