Acetabular fractures, although relatively rare, are often serious injuries requiring complex treatment. Major associated injuries are common and the mortality rate continues to approach 20% (8).We retrospectively evaluated 38 acetabular fractures. Twenty-six fractures were treated operatively, with adequate followup available for 23. Anatomic reduction or reduction to within 3 mm was achieved operatively in 21 (81%). The average Harris hip score was 90. The five poorly reduced fractures had an average Harris hip score of 54. Twelve patients were treated nonoperatively with adequate followup available for nine. Six patients with nondisplaced or minimally displaced fracture treated nonoperatively had an average hip score of 96. Six patients had displaced fractures which failed to reduce with nonoperative treatment. Their average hip score was 59.This study reaffirms the importance of adequate fracture reduction in the treatment of acetabular injuries.