Acetabular dysplasia is increasingly recognized as a cause of pain and eventual osteoarthritis in young active patients. Treatment of acetabular dysplasia with hip arthroscopy alone (without acetabular reorientation) has been shown to be at high risk for failure and is unlikely to alter the natural history of the condition. Periacetabular osteotomy (PAO) has become the gold standard for the treatment of acetabular dysplasia with excellent mid-term outcomes and low complication rates. However, significant labral pathology due to acetabular rim overload is present in a subset of patients and some patients have persistent symptoms after PAO. Combined hip arthroscopy and PAO allows for simultaneous treatment of labral pathology and acetabular reorientation. We have utilized this combined procedure in a subgroup (approximately 30-40% of all patients undergoing PAO) of patients presenting with significant mechanical symptoms and MR imaging consistent with labral pathology. Central compartment hip arthroscopy is performed to address labral and chondral pathology. Osteoplasty of the proximal femoral head-neck junction is performed via an open capsulotomy at the time of PAO, followed by capsular repair. We have experienced excellent outcomes and low complication rates in our initial experience of more than 100 combined procedures. The current surgical technique video presents our technique for combined hip arthroscopy and PAO.