The past decade has brought a number of advances in the use of hip arthroscopy to diagnose and treat intra-articular pathology of the hip joint. As such, hip arthroscopy has been used to treat patients who otherwise may have needed a complicated open procedure or have gone untreated. The history and physical examination of the patient as well as imaging modalities, such as magnetic resonance imaging, play a vital role in determining a successful outcome. Patient selection also is an important component of success. As the technique and instrumentation of hip arthroscopy improves, this procedure will become increasingly commonplace in addressing patients with hip pain.