We evaluated the utility and the safety of arthroscopy for diagnosing and treating symptoms in patients with osteoarthritis (OA) of the hip. We studied 133 patients consecutively treated for hip OA, using a modified Harris Hip Score (HHS) for the clinical assessment: There were no related complications or infections. At an average follow-up of 18 months, 61% of patients showed an improvement of their preoperative score, although only 36% of those actually presented good or excellent results. The remaining 39% of the total, either developed recurrent symptoms or underwent a major surgical procedure after arthroscopy. Benefit derived from the arthroscopy procedure depends strictly on either age or OA severity. Arthroscopy of the hip joint is a safe tool for managing problems related to OA of the hip. Careful selection of patients must be performed to identify those who will benefit most from the procedure. It seems that young patients with early OA are those associated with a higher rate of procedure success.