Femoroacetabular impingement is defined as anterior hip abutment between the acetabular rim and proximal femur. When it is secondary to acetabular overcoverage, it is pincer impingement. When it is secondary to femoral head and neck deformity, it is cam impingement. Open remodeling of impinging deformities is the standard treatment of this condition. We describe arthroscopic treatment of cam impingement in 19 patients using standard hip arthroscopy portals by the lateral approach. Sixteen patients improved their symptoms after the procedure; and 3 patients deteriorated, with 1 needing a total hip arthroplasty at 2 years follow-up. We had no cases with postoperative femoral neck fractures or avascular necrosis. Hip arthroscopy can be successfully used to treat cam impingement. The precautions used in open surgery to preserve femoral neck bone stock and hip vascularity should be followed.