There is presented a comparative characteristic of the clinical and radiological picture of congenital and neurogenic spastic instability of the hip in children, the peculiarities of surgical treatment of these pathologies have been revealed. The work is based on an analysis of the results of surgical treatment of 115 patients (205 hips) who were divided into 2 groups. The first group included 58 patients (50.4 %) with spastic hip instability. The second group (57 patients, 49.6%)) was consisted of patients with dysplastic instability in. indications for various types of surgeries were pathogenetically substantiated.