Joint involvement occurs in about half the patients with hereditary hemochromatosis and may constitute the presenting manifestation. Joint damage is now the main cause of quality-of-life alterations in patients with hereditary hemochromatosis. The most common sites of involvement are the metacarpophalangeal joints and the hip. We report a case that illustrates the clinical, imaging-study, and pathological characteristics of hip disease in hereditary hemochromatosis.