All newborn infants delivered at King Fahd Hospital of the University in Al-Khobar between June 1982 and May 1987 were subjected to routine physical examinations, including the Ortolani and Barlow maneuvers for detection of hip instability. A total of 12,733 neonates were screened, and a positive test was found in 62 (0.49%). Infants with a positive test were placed in a von Rosen splint for 6 to 8 weeks. Five "missed" cases were diagnosed later, all of whom were born during the first year of the study. Male-to-female ratio was 1:4.2. Bilateral hip instability was seen more commonly in males than females. Known factors that increase the risk of hip instability include breech presentation and large weight for gestation. Follow-up was possible in 47 patients; all were asymptomatic except for one with poor compliance who required further surgical intervention. The importance of neonatal screening and continued follow-up for detection of hip instability among all hospital-delivered babies is stressed to prevent the hazards of late diagnosis.