Femoral head fractures after posterior dislocation of the hip are uncommon and are conventionally treated by an open method. Hip arthroscopy can be a valuable treatment option for the management of femoral head fractures. Arthroscopy allows for a less invasive option when compared with arthrotomy and can allow faster recovery with minimal soft-tissue injury. We describe the arthroscopic reduction and internal fixation of Pipkin type I femoral head fractures with a detailed stepwise description of the surgical technique, including technical pearls and pitfalls, potential complications, and advantages and disadvantages.