Acetabular fractures are known for their disabling outcomes, so the search for optimal treatment tactics is an actual problem for modern orthopedics and traumatology. Materials and methods. Randomized trials that reflect the results of acetabular fractures treatment depending on the method of treatment were analyzed. The literature was searched in the PubMed Central database. Hip joint is a complex two-component articulated system. Traumatic lesion of all elements of the joint creates the conditions for the development of a wide range of complications and secondary changes that must be taken into account at preoperative treatment. Acetabular fracture is an intra-articular injury, where the visualization methods have the prominent significance. Nowadays the treatment can be conservative and surgical. Surgical treatment can be divided into two areas: osteosynthesis and arthroplasty. Anatomical reposition and stable fixation of fragments, in the most of cases, is the key to a satisfactory functional result, but the development of post-traumatic changes in the joint nullifies the results of even perfect osteosynthesis, encourages repeated surgery and, finally, hip replacement. In recent years, primary arthroplasty has been successfully used to treat acetabular fractures, reducing inpatient and rehabilitation period, compared with osteosynthesis, preventing the possible development of secondary degenerative changes in the joint. Conclusions. Acute hip replacement is an effective treatment, however, the technical aspects of reliable fixation of the acetabular component of the implant are insufficiently substantiated and highlighted in actual literature and constitute significant research interest.