The role of ultrasound (US) in the diagnosis and management of infants with developmental dysplasia of the hips (DDH) is becoming widely accepted. In our community, there exist three delivery systems for US-DDH: the radiology based, the combined radiology/orthopaedic based, and the orthopaedic office based. This study reviewed the costs and benefits of each delivery system and found that once expertise had been gained and start-up costs were met, the orthopaedic office-based system was the most convenient, efficient, and cost effective for the patient/family and treating physicians. This mirrors the experience of cardiologists, obstetricians, and family practitioners, fields in which the utility of office-based ultrasonography is widely recognized and has become the standard.