The goals of treating an acetabular fracture are to restore the congruity and stability of the hip joint. Some fracture types may not require surgery for a satisfactory outcome, but a displaced fracture in the weight-bearing area of the acetabulum generally should be treated with open reduction and internal fixation. The surgery is complex and demanding, and the fracture reduction must be anatomic to obtain the best result. There is no doubt, however, that an experienced surgeon can achieve an excellent result. Usually a poor result is related to residual fracture displacement or a perioperative complication. The evaluation and treatment protocols initially developed by Letournel and Judet continue to be important; in addition, the surgeon should be aware of the progress made during the past decade.