The initial damage to the joint in septic arthritis occurs from local products liberated by the bacteria and the host’s inflammatory response. The sequelae can result in considerable disability especially when the infection occurs in a weight-bearing joint such as the hip. Treatment must be individualized and depends on whether stability or motion is the goal, as well as the resources and expertise available. While a stable and painless joint may be the goal for some joints (ankle, wrist, or knee), treatments that preserve motion are more desirable at the hip and elbow. In austere environments, salvage, rather than reconstruction, may be the better option as irreversible changes in the joint and surrounding tissues are common due to delays in presentation or complications of previous treatments that are difficult to predict and correct.