Despite considerable research and the application of screening programs during the past three decades, the incidence of canine hip dysplasia (CHD) remains disturbingly high. Mild CHD is underdiagnosed by subjective evaluation of adult dogs, and moderate CHD is underdiagnosed by subjective assessment of immature dogs. Coxofemoral subluxation measurement methods hold promise for increasing the accuracy of CHD assessment, especially in 4-month-old dogs. Many radiologists have greater confidence in the PennHip method than in subjective hip assessment alone for dogs 6 months of age or younger. The incidence of CHD is unlikely to be dramatically reduced until CHD registries are open to the public and CHD examination is required for purebred dog registration.