Recent literature suggests that, in older children, acute cases of septic arthritis may be treated with aspiration and intravenous antibiotics. However, when surgical decompression is required, the technique described in this report has several advantages. It can be performed with an incision of approximately 1 to 2 inches and a posterior stab wound of <1 cm; it preserves anatomic planes and poses less risk to the circumflex femoral vessels (as with the anterior approach); and it allows fluid to drain when the patient is supine (as with the posterior approach).