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Borderline dysplasia represents a \u201ctransitional acetabular coverage\u201d pattern between more classic acetabular dysplasia and normal coverage. Traditionally, borderline dysplasia has been defined by a lateral center\u2010edge angle between 20\u00b0 and 25\u00b0, whereas more recently, some authors have used 18\u00b0 to 25\u00b0. Treatment decisions between isolated hip arthroscopy (addressing labral tears, femoroacetabular impingement morphology, and capsular laxity) and periacetabular osteotomy (improving joint stability, often combined with arthroscopy) remain challenging because the fundamental mechanical diagnosis (instability vs femoroacetabular impingement) can be difficult to determine clinically. Obtaining an accurate diagnosis to direct surgical treatment relies on comprehensive assessment of additional bony anatomy features (including femoral version) and patient characteristics (including sex, soft\u2010tissue laxity, and range of motion). 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