OBJECTIVE:To explore factors influencing participation in physical activity for young to middle-aged patients at six months post-hip arthroscopy. DESIGN:Qualitative study. SETTING:Three specialist surgical centres in Australia. PARTICIPANTS:Seventeen adults aged 18-50 years. MAIN OUTCOME MEASURES:Individual semi-structured interviews were undertaken and transcribed verbatum. Inductive analysis of the data was undertaken, with themes identified through an iterative coding process. RESULTS:Four key themes emerged from the analysis: 1) an evident mismatch between expectations and actual progress of physical activity during the first six months post-arthroscopy; 2) physical activity levels vary widely at six months post-operatively; 3) evidence of suboptimal psychological readiness to return to sport and an associated emotional toll; and 4) the influence of available support and information on post-operative physical activity. CONCLUSIONS:This qualitative study has provided in-depth perspectives on recovery after hip arthroscopy. Clear opportunities exist to: 1) help patients develop realistic post-operative goals; 2) provide timely patient education and support; and 3) facilitate an effective transition to desired physical activity.