Fifty patients (60 hips) aged >18 months to 6 years old with developmental dysplasia of the hip (DDH) scheduled for an open reduction, Pemberton pelvic osteotomy (PPO), and femoral shortening osteotomy were randomized to receive either iliac autograft (n=30 hips) or femoral autograft (n=30 hips) after PPO. Outcomes of interest included the following: acetabular index angle (AIA), time of surgery, mean blood loss, mean time to graft union, mean graft height and width, mean loss of graft height and width, and the incidence of complications (i.e. loss of graft position, graft resorption). AIA was evaluated at 1-day, 45-days, and 1-year post-surgery, whilst mean graft height, was assessed at 45-days and 1-year post-surgery. All other outcomes, excluding mean loss of graft height which was evaluated at 90-days follow-up, were measured peri-operatively. Results of this study demonstrated that the mean AIA, mean surgical time, and incidence of adverse events were not statistically significantly different between the two graft groups (p>0.05 for all). Furthermore, mean peri-operative graft width, mean graft height, mean loss of graft height, and mean blood loss were all statistically significantly in favour of the femoral autograft group (p<0.001 for all). Yet, mean time to graft union was statistically significantly in favour of the iliac autograft group (p=0.0001). Two patients experienced loss of graft position, and 1 patient experienced graft resorption. No cases of superficial/deep infections, neurovascular injury, or nonunion at the osteotomy line were observed in either group.