Thirty-seven consecutive patients with unstable pelvic fractures were divided into two groups: Group 1 (July 1981 to December 1984;n= 18), when early fixation was not routinely used, and Group 2 (January 1985 to March 1988;n= 19), when early fixation was performed unless contraindicated.Hospital stay decreased by 37.8% in Group 2 (p= 0.04). Of Group 1 patients, 60% were disabled for at least 6 months versus 15.7% in Group 2 (p= 0.001), and 45% were discharged to a rehabilitation facility versus 26.4% in Group 2. Group 1 had more complications, 1.3 per patient, versus 1.0. Patients in Group 2 (undergoing early fixation) required 27.2% fewer units of blood than those in Group 1 in whom fracture surgery was delayed. Survival was better in Group 2, 100% versus 83.3% (p= 0.06). Early pelvic fracture fixation reduces hospital stay, long-term disability, and may result in fewer complications, decreased blood loss, and better survival.