We performed dome pelvic osteotomy in 57 hips (54 patients) because of acetabular dysplasia. All patients had preoperative scintigraphy and were followed for more than 2 years. Excellent or good results were obtained in 49 hips, but 8 hips deteriorated. All hips which deteriorated had preoperatively a spotty isotope uptake image localized to the weight bearing area and the medial area of the joint. No hip without this image deteriorated, even when preoperative radiography showed advanced arthrosis. Our findings indicate that bone scintigraphy may be a more reliable predictor of failure for this operation than radiography.