PURPOSE: Hip arthroscopy is commonly performed on an outpatient basis; however, many are still performed in hospital operating rooms (HOR) over ambulatory surgery centers (ASC). Therefore, this study aimed to compare patient demographics and complications between hip arthroscopies performed in HOR and ASC. MATERIALS AND METHODS: This was a retrospective cohort study (level III evidence) of 832 patients who underwent hip arthroscopy between 2014-2022 at a multi-hospital academic health system. Nine hundred four hip arthroscopies were performed, 72 of which were staged bilateral. Demographics, procedure details, and complications were recorded from the electronic medical record. Clinical environments were compared by using chi-squared tests with adjusted residuals (ARs), Welch's -tests, and binary logistic regression. RESULTS: Eight hundred eighty-one cases were performed in HOR while 23 cases were conducted at ASC. Patients with at least one medical comorbidity (91.4% vs. 65.2%, AR=4.3) or who required 3 or more suture anchors (31.7% vs. 4.3%, AR=2.8) were more likely to undergo surgery in HOR. Femoroplasty (87.0% vs. 57.8%, AR=-2.8) and capsular repair (69.6% vs. 47.6%, AR=-2.1) had increased likelihood of being performed at ASC. There were no differences found in returns to the operating room or readmissions. Postoperative emergency department (ED) visits were more common in patients treated at HORs (3.0% vs. 0.0%, AR=-2.7). CONCLUSION: ASCs and HORs both provided safe operating environments. ED visits were higher in patients treated at HORs during the 90-day postoperative period, often due to their comorbidities rather than as a direct sequela from surgery.