Hip osteoarthritis is a common degenerative joint disease, and the exact pathogenesis remains incompletely understood. However, substantial evidence suggests that local anatomical abnormalities of the hip joint are risk factors for the development of hip osteoarthritis. Morphological abnormalities such as acetabular dysplasia and femoroacetabular impingement syndrome may play important roles in the onset and progression of hip osteoarthritis. From an imaging perspective, this review summarized the radiographic assessment methods, clinical significance, and recent research advances related to hip morphological abnormalities—including acetabular dysplasia, femoroacetabular impingement, and coxa vara/valga—associated with hip osteoarthritis. The aim is to enhance the understanding of hip osteoarthritis and provide guidance for clinical diagnosis and treatment.