Abstract Background Hip pain is a frequent complaint in the pediatric population, in orthopedics, and in rheumatology. In children, the clinical features of hip pain vary widely according to age. This clinical variability represents a diagnosis challenge for clinicians. This study aimed to identify the clinical, paraclinical, and etiological spectrum of hip pain in children. Methods A retrospective, descriptive study was conducted between January 2017 and December 2020. We included children aged under 16 years who were hospitalized in the rheumatology and/or pediatric orthopedics department at Mohamed Kassab orthopedics institute for non-traumatic hip pathology. Clinical, biological, and radiological data were collected from recorded medical files. Missed anamnestic data were collected from parents by telephone call. Results We included 81 children. Male predominance was noted (48 boys and 33 girls). The mean age was 9.9 ± 4.4 years with extremes from 1.3–16 years. Limping was the presenting feature in 84.4% of children, followed by pain (76.5%) and refusal to bear weight (12.3%). The mean time of onset to presentation was 8.8 ± 21.3 months. The mean diagnosis delay was 3.5 ± 15.3 months with extremes from 0 to 10 years. Fifty-four (66.7%) children visited their physician at least once before diagnosis. In clinical examination, fever was found in 12 children, and local inflammatory signs in 2 children. Leg length discrepancy was noted in 13 children, hip joint pain in 47 children, and restricted hip movement in 58 children. Elevation of erythrocyte sedimentation rate was noted in (23/28) of children and elevation of C reactive protein in (14/33) of children. An elevated leucocyte count was present in (10/79) patients. Radiographs showed anomalies in 76.5% of cases and Ultrasonography in 90.9% of cases. The final diagnoses of our sample were: slipped capital femoral epiphysis (37%), juvenile idiopathic arthritis (18.5%), hip dysplasia (14.8%), septic arthritis (12.3%), transient synovitis (8.6%) and tumors (4.9%). The chirurgical approach was conducted in 71.6% of patients. Most children (72.5%) had benign outcomes. Conclusion The diagnosis of pediatric hip pain should always follow a standard algorithm. This starts with taking a detailed history from the patient, if possible, and parents and conducting a thorough clinical examination; imaging and/or blood tests may follow if necessary. Ethics The authors declare that they have no conflict of interest.