First carpometacarpal joint arthritis represents 10% of all possible sites of arthritis. It is a common condition seen in hand clinics all over the world and is often associated with other pathologic conditions, such as carpal tunnel syndrome and scaphotrapezial arthritis. Arthritis of this joint more commonly occurs in women than in men, starting in middle adulthood and increasing in prevalence with age. Symptoms include pain, swelling, deformity, and instability. The most common classification used is Eaton-Littler, which describes four stages of first carpometacarpal arthritis based on a true lateral radiograph of the joint with the sesamoid bones superimposed on one another. The mainstay of initial treatment of basal thumb arthritis of stages I and II is activity modifications, physiotherapy, rest, splinting, NSAIDs, and hyaluronate or corticosteroid joint injection. Surgery is indicated when the conservative treatment fails or in stages III and IV. A variety of surgical procedures are available, among which trapeziometacarpal arthrodesis, trapezial excision with ligament reconstruction, and tendon interposition (LRTI), or suspension arthroplasty, are the most common. Since the first description of thumb carpometacarpal joint replacement in 1973 by de la Caffinière, many types of prostheses have been developed. Partial and total joint arthroplasty with cemented and uncemented prosthesis has been described for the treatment of trapeziometacarpal (TM) joint osteoarthritis. Patients for whom this treatment is indicated include those who perform jobs requiring little repeated force movements in the pollicidigital pinch. Retired patients with low functional demand but for whom speed of return to activity is a priority are also good candidates. Patients affected by advanced osteoarthritis and patients whose jobs involve strenuous manual work are not good candidates for total arthroplasty today. We prospectively collected data for 152 TM joint replacements (stage II to III according to the Eaton-Littler classification): 134 women and 18 men. The mean age was 70 years. A dual mobility TM prosthesis with a conical trapezial cup was implanted in all cases, and all surgeries were carried out by the same surgeon. Patients' satisfaction; grip strength; pinch strength; thumb range of movement; Kapandji opposition scores; Quick Disabilities of the Arm, Shoulder and Hand (DASH) score; visual analog scale score; and radiographic evaluation results were assessed pre and postoperatively, at 0, 1, 3, 6 and 12 months after surgery. In our experience, the patients examined have shown excellent clinical and functional results starting from the 1-month follow-up. Excellent results were maintained at the 12-month follow-up. There were no intraoperative or postoperative complications and, at the last follow-up, there was no evidence of loosening of the cup or migration of the stem, subluxation, or dislocation of the prosthesis. In conclusion, the results of the dual-mobility TM prosthesis for the treatment of TM joint osteoarthritis are excellent with significant and rapid improvement in pain and disability and, as a result, in the quality of life.