Hip osteoarthritis (OA) poses as challenge in determining the efficacy and indications for hip arthroscopy. Although joint-preserving procedures are commonly employed for low-grade OA, such as OA accompanying femoroacetabular impingement or labral tear accompanying dysplasia, an optimal management strategy has not yet been established. Studies have reported varied outcomes after hip arthroscopy in patients with OA, with some reporting higher rates of total hip arthroplasty conversion, emphasizing the importance of patient selection. Factors such as the Tonnis grade, joint space narrowing, age, and impingement type have been implicated as prognostic indicators. However, evidence regarding the effectiveness of arthroscopy for higher-grade OA remains conflicting. Labral management in OA is complex, with limited research on optimal treatment strategies. The scarcity of prospective studies and conflicting results underscore the need for further research to establish clearer guidelines on hip arthroscopy for OA.