Lateral femoral insufficiency fracture in total hip arthroplasty occur due to osteopenia and varus positioning of the femoral component. The presentation of these fractures usually involves the insidious onset of unexplained thigh or groin pain. The insufficiency fracture generally occur at the level of the femoral stem tip on the lateral cortex of the femur. Recommended treatment involves revision to a long stem femoral component. This is the first report of lateral femoral insufficiency fracture simply regarded as periprosthetic fracture of the femur.