Recent advances in the management of septic arthritis of the hip in children include a better understanding of the effects of infection on articular cartilage; improvements in diagnostic tests, including erythrocyte sedimentation rate, C-reactive protein analysis, and ultrasonography; and more efficacious home intravenous and oral antibiotic therapy. Early diagnosis is essential to successful treatment. Needle aspiration is the most specific diagnostic test; however, false-negative results are possible. Prompt surgical drainage and postoperative antibiotic therapy until signs of infection resolve are necessary to prevent late sequelae. Surgical treatment of limb-length inequality is more useful than attempts to salvage the destroyed or incongruent joint.