Arthroscopic hip surgery has evolved from a purely theoretical concept to a vital pillar of modern orthopaedic surgery over the last 100 years, driven by innovation and technological development. However, the foundations for hip arthroscopy began much earlier with the development of Bozzini’s ‘Lichtleiter’, an early endoscopic device able to illuminate internal body cavities, in the early nineteenth century. The first recorded hip arthroscopy was performed on cadaveric specimens in 1931 by Burman, who concluded that the hip joint was largely inaccessible due to its deep anatomy and lack of joint distraction techniques. This led to several decades of stagnation. However, technological developments in the mid-twentieth century prompted a resurgence in interest in arthroscopic surgery, spearheaded by Watanabe—the ‘father of modern arthroscopy’. The identification of labral pathology as a source of hip pain, in addition to the development of crucial novel techniques such as Glick’s lateral approach and the use of traction to enable access to the central compartment of the hip in the 1970s and 1980s, greatly increased both interest in and the capabilities of hip arthroscopy. This momentum continued into the 1990s: it was during this period that hip arthroscopy developed from a purely diagnostic tool into a therapeutic procedure. The recognition of femoroacetabular impingement as a significant cause of osteoarthritis has defined the modern (post-2000) era and has driven an exponential increase in arthroscopic hip surgeries performed. This recent explosion of hip arthroscopy can also be attributed to the establishment of dedicated societies, refined instrumentations and the expansion of indications to include complex soft tissue and bone pathologies. The growth and evolution of hip arthroscopy as a specialty are the result of consistent innovation, perseverance and collaboration between a truly global community. Despite significant anatomical challenges, this effort has transformed hip arthroscopy into a staple of modern orthopaedic surgery, capable of diagnosing and treating a wide range of hip pathologies.