Background: The acetabular and proximal femoral bone abnormalities are very common in the clinical practice. Conventional radiography has some difficulties in detecting early osseous changes. Digital tomosynthesis (DT) can remove the overlap of the anatomical structures, which improves the detection of early osseous changes. A special functional position can simulate the status of clinical symptoms; provide more evidence for clinical study of the acetabular and proximal femoral bone abnormalities and improve the accuracy. Objectives: To evaluate the diagnostic value of hip digital tomosynthesis at special functional position (DT-SFP) in detecting acetabular and proximal femoral radiographic abnormalities compared with conventional radiography. Patients and Methods: Ninety-four consecutive patients with discomfort around the hip joint underwent DT-SFP and conventional radiography. The imaging features of the acetabular and proximal femoral bone abnormalities were analyzed and the detection rate of the two methods was compared by chi-square test. Results: The herniation pits (HPs) of the femoral neck, acetabular/labral ossification, femoral head-neck junction bone protrusion, acetabular cysts, and acetabular osteophytes were detected by DT-SFP and conventional radiography. The detection rates of DT-SFP were 35%, 21%, 33%, 17% and 40% respectively, which were significantly higher than conventional radiography (21%, 9%, 10%, 7% and 31% respectively) (P = 0.000, 0.000, 0.000, 0.000, 0.001). The detection rate of coxa profunda, posterior wall sign and hip joint space narrowing showed no significant difference between using DT-SFP and conventional radiography (41%, 8% and 6% respectively) (P = 1.000, 1.000, 1.000). Conclusion: DT-SFP can improve the detection of relatively early bone abnormalities in acetabular and proximal femur compared with conventional radiography. DT-SFP can also observe the abnormal impact between acetabular and proximal femur.