Hip preservation has re-emerged after decades dominated by total hip arthroplasty, driven by advances in arthroscopy, imaging, and a deeper understanding of femoroacetabular impingement (FAI). FAI has roots in early 20th-century concepts, later shaped by pioneers like Ganz and Philippon, and is now a rapidly expanding field with rising case volumes, improving technology, and growing academic interest. Discussion centered on diagnosis—anchored in careful history, physical exam, imaging, and diagnostic injections—and on how personality, pain perception, and kinesiophobia influence outcomes in young athletic patients. Emerging data suggest early specialization in high-rotation sports during adolescence may promote FAI morphology, while overall sport participation still supports well-being. The conversation highlighted gaps in volume-outcomes research, the complexity of learning curves, and the need for collaborative multidisciplinary hip-preservation teams rather than expecting surgeons to master all procedures.