Background: Developmental dysplasia of the hip (DDH) is a musculoskeletal condition occupying any point along a spectrum of anatomical abnormalities that alter the stability of the newborn hip. Ultrasonography is the most reliable imaging method for the diagnosis of DDH before femoral head epiphyseal nucleus ossification. The study aimed to assess the capability of ultrasound in detecting the developmental dysplasia of hip in high risk neonate. Methods: This was a prospective study that included 50 babies who were at risk of developing DDH and were candidates to USG imaging. The study was conducted at Central teaching pediatric hospital in Baghdad /Iraq and the radiology departments of Benha University, Egypt. Results: According to diagnosis of DDH by USG 9 (18%) pf babies was giagnosed to have a degree of DDH while 41 (82%) were normal according to USG findings. According to Graf's classification , 41 (82%) baby was type I (normal) and 8 (16%) baby was Type II graf (immature or abnormal) and only one baby (2%) was Graf Type III . According Validity of USG in Diagnosis of DDH, Sensitivity was 100%, Specificity 89.13% and Accuracy of USG in diagnosis DDH was 89.24%. Conclusion: USG is an accurate and effective tool for routine screening for early diagnosis DDH in high risk neonates with or without presence of risk factors alone. Patient characteristics that were found to be significant risk factors were breech delivery and positive family history.