Chiari osteotomy as the therapeutic approach in congenital hip dislocation has a special value in the adolescent patient with acetabular dysplasia and femoral head subluxation. The advantage is in the preservation of as much as possible of the modeling relationship of femoral head and acetabulum involved in hip joint motion while creating an effective lateral femoral head cover. Experience with Chiari osteotomy is described in a small group of adolescents (average age, 14 years) whose clinical problem is associated with limp, increasing fatigability and recurrent pain, with discussion of the complications contributing to significant morbidity, the technique of performance and the relative advantages and disadvantages of the procedure.