Background <p>Coxarthrosis is one of the most frequent degenerative joint diseases and increasingly affects younger active patients. While total hip arthroplasty is the gold standard in advanced stages, hip arthroscopy is gaining attention as a&#xa0;joint-preserving procedure especially in early stages of the disease or with concomitant femoroacetabular impingement (FAI); however, the efficacy in moderate to advanced osteoarthritis remains uncertain.</p> Objective <p>This review critically evaluates the indications, outcomes and limitations of arthroscopic salvage procedures for coxarthrosis based on the current evidence.</p> Material and methods <p>A&#xa0;selective literature search was performed including studies on patients with radiologically confirmed coxarthrosis (Tönnis grades 0–3). Outcomes assessed were pain relief, function, return to work and long-term results regarding conversion to total hip arthroplasty.</p> Results <p>In patients with mild osteoarthritis (Tönnis 0–1) arthroscopy showed significant clinical improvements and could delay progression. In advanced coxarthrosis (Tönnis ≥ 2) the effects are clearly limited with conversion rates to arthroplasty up to 44% within 2&#xa0;years. Some subjective improvements are reported but do not always correlate with objective findings.</p> Discussion <p>Hip arthroscopy is not a&#xa0;standard treatment for coxarthrosis but can be considered in selected cases with moderate degeneration and defined therapeutic goals. In advanced stages the long-term benefits are limited and the prosthesis conversion rates are high. The indications must be individualized considering the joint structure and patient expectations. Further high-quality prospective studies are needed for a better definition of the role of arthroscopy.</p>