In our multicenter treatment study on pediatric nonneonatal osteoarticular infections we had 62 septic hip arthritides. All had confirmed joint effusion, were culture-positive, and Staphylococcus aureus was isolated in 71% of the cases. Sixty-one of the 62 had a diagnostic joint aspiration. Following protocol, arthrotomy was to be performed only if the response to antimicrobial treatment was slow. The course of illness was monitored by preset criteria. Analysis of 95% of the patients who attended the last checkup ≥1 year posthospitalization showed that invasive surgery had been avoided in 81% of the patients. All patients recovered completely. Routine arthrotomy in nonneonatal hip arthritis warrants reconsideration.