Following careful study, the Ganz periacetabular osteotomy was introduced in 1988 for the treatment of adolescent and adult hip dysplasia. It offers a powerful and versatile ability to reorient the acetabulum, restoring near-normal biomechanics, improving symptoms, and delaying or preventing osteoarthritis. This article outlines hip dysplasia and the biomechanical deficiencies, the assessment of patients who have hip dysplasia, and the technique of performing the osteotomy. The early and mid follow-up radiographic and clinical outcomes are reviewed and complications associated with the procedure are discussed.