Cam-type femoroacetabular impingement (FAI) occurs due to the presence of an aspherical femoral head–neck junction causing pathological contact with the acetabular rim during motion, which can lead to labral and chondral damage and in some cases arthritis. Surgical management options include open surgical dislocation or hip arthroscopy. While different in their approach, the principle of surgical correction for both techniques is the same: to restore head–neck offset and relieve impingement. Open surgical dislocation provides excellent access to the hip joint, enabling comprehensive evaluation and precise osteochondroplasty, and it, therefore, remains as the gold standard for the treatment of a wide range of complex or severe deformities including slipped capital femoral epiphysis and Perthes disease. However, the inherent invasiveness and associated rehabilitation demands of open surgery have driven the development of minimally invasive techniques. Hip arthroscopy replicates the core principle of open osteochondroplasty while minimizing soft tissue trauma and accelerating rehabilitation. This approach enables direct visualization of intra-articular pathology and treatment of cam deformities, in addition to associated chondral defects and labral tears depending on arthroscopic findings. Preoperative planning using magnetic resonance imaging (MRI) and three-dimensional (3D) computed tomography (CT) collision analysis is essential for detailed assessment of impingement morphology and achieving surgical accuracy. Careful management of traction time, fluid extravasation, and capsular repair is key to minimizing complications. Both open and arthroscopic techniques are associated with favorable outcomes, demonstrating improvements in pain and function, and facilitating return to sport.