This paper describes a methodology for designing custom hip implants based on standard X-ray films for the cases when the patient’s bone are not suitable for a standard hip implant. Software was developed that includes X-ray scanning, femoral canal obtaining, implant designing, fit evaluation, and drawing a 2D map. Hip implants can then be manufactured using the CAM (Computer Aided Manufacturing) technique. The design procedures, rationales are explained. Verification of a custom hip implant is presented in results and discussion of this paper. It was concluded that the hip implant matched the femoral cavities very well. The result of verification indicates that the method of designing hip implants is practicable.