The indication for operative treatment of displaced acetabular fractures is widely accepted. The radiologic diagnostics consist of the a.p. pelvic view and the oblique ala and obturator views. With the X-rays and the additional CT images the fracture is classified according to Letournel or to the AO Classification into an A, B or C-type fracture. The appropriate surgical approach is chosen depending on the classification and the site of the main dislocation. Extended or combined approaches are only indicated for complex or older fracture patterns. Osteosynthesis is performed either with small fragment cortical screws in lag screw technique or with reconstruction plates. In about 80% of the cases an anatomical reduction of the joint is possible as prerequisite for good functional results. First clinical trials with computer- and/or CT-assisted procedures are promising. In future computer- and robotics-based procedures will gain increased importance with reduced patient morbidity and improved reconstruction of the joint surface.