Hip arthroscopy became an alternative to open surgery but only if cartilage damage is small. Introduction of arthroscopy lead to new therapy paths. The most well known disease is femuro-acetabular impingement (FAI). It includes CAM- and Pincer-impingement. Nevertheless success is not comparable yet with the success of hip implants. Meanwhile it is easier to better detect cases with good chances of possible improvement through arthroscopy. In many cases the second step might be hip replacement.