Nearly 15% of all cases of osteoarticular tuberculosis occur in the hip joint. Diagnosis in early stages (Synovitis) is difficult. Careful clinical examination, X-rays, newer imaging modalities and laboratory investigations help reach the diagnosis. In case of doubt biopsy must be obtained from representative diseased tissue for bacteriological, histological and serological examination. Functional outcome of treatment depends upon the stage at which the treatment was initiated. Operative treatment is needed in non-responders: synovectomy with or without debridement in early stage of disease, joint reposition in case of pathological dislocation, excisional arthroplasty or joint replacement in adults, juxta-articular corrective osteotomy to correct the deformity or to bring a useful range of movements to the best functional arc. Steps of these operations are outlined with relevant surgical anatomy.