Hip tuberculosis (coxotuberculosis) is the third most common form of bone and joint tuberculosis, accounting for about 15% of cases, after the spine and knee. The common age of onset is from the late teens to the early twenties, and the disease is mostly unilateral. In the early stages, simple synovial tuberculosis is common, and the lesions of simple bony tuberculosis are often located at the superior border of the acetabulum, followed by the femoral head and femoral neck near the epiphyseal plate. Localized lesions show bone destruction with dead bone and cavities and slightly dense surrounding bone. Abscess formation is more common in simple bone tuberculosis. Presentation: Very insidious, with only 1/3 of patients having a history of tuberculosis. The onset of the disease is slow, with systemic symptoms such as low-grade fever, fatigue, lethargy, lack of appetite, emaciation, and anemia. The clinical manifestations of typical cases include claudication and pain in the affected hip. In the early stage, the symptoms are only lameness and discomfort in the affected hip. Children often cry at night, and hip movement is limited by pain. In the early stage, there may be pressure pain on the anterior side of the hip joint, but the swelling is not obvious, followed by significant atrophy of the quadriceps muscle. The affected limb appears to be flexed, abducted and externally rotated deformity, and with the development of the disease, the hip joint is flexed and internally rotated deformity. Examination: 1, tuberculin test can be used as a diagnosis and reference, but the false negative rate is as high as 20%, so tissue biopsy and culture are usually taken. 2. Early changes on X-ray may not be obvious, and orthopantomographs of the pelvis must be taken to compare both sides of the hip joint. Localized osteoporosis can be seen, and if there is mild narrowing of the joint space, it should be noticed. In the later stages of the disease, destructive arthritis with a small amount of reactive sclerosis is seen. Occasionally, complete destruction of the joint, with cavities and dead bone, may occur rapidly within a few weeks. In severe cases, the head of the bone and femur almost disappears. Pathological dislocation may occur in the later stages. CT and MRI can help in early diagnosis, CT is particularly useful in guiding fine needle aspiration or biopsy, and MRI is useful in identifying early bone marrow changes, joint effusion and cartilage destruction in tuberculous osteomyelitis and arthritis. Treatment: Early diagnosis and prompt treatment can be effective in preventing severe joint destruction and skeletal deformity. This includes medication, traction and immobilization with close follow-up, and surgery. Systemic supportive therapy and the use of anti-tuberculosis drugs are important to improve the patient’s general condition and as preoperative preparation and postoperative treatment. Early treatment with drugs, traction and immobilization is effective. Patients who do not respond well to conservative treatment should be treated surgically before joint destruction.