Abstract: Objective To study the surgical treatment outcome of complex acetabular fracture in order to improve its diagnosis and treatment. Methods Data about 34 patients（25 males and 9 females） with complex acetabular fracture at the average age of 36.6 years,who were treated with surgery in our hospital from August 2005 to September 2008,were retrospectively analyzed.Fractures were classified as posterior column combined posterior wall fracture in 2 patients,transverse combined posterior wall fracture in 7 patients,T-shaped fracture in 8 patients,anterior combined posterior hemitransverse fracture in 4 patients,and both column fracture in 13 patients,respectively,according to the Letournel classification.Fracture reduction and fixation were carried out with special instruments,plates and screws through Kocher-Langenbeck + ilioinguinal approach in 15 patients,extended iliofemoral approach in 1 patient,combined anterior and posterior approach in 6 patients. Results All the patients were followed up for 12-36 months（mean 20 months）.Anatomical,satisfactory and poor reduction was achieved in 19,10 and 5 patients,respectively.According to the Matta scores,excellent,good,fair and poor results were found in 15,9,7 and 3 patients respectively.Traumatic arthritis,femoral head necrosis and heterotopic ossification occurred in 9,3 and 9 patients,respectively,after operation. Conclusion Early operation,anatomical reduction,good fixation,early functional rehabilitation,surgeon’s experience and active prevention of complications are the keys to a good clinical outcome.