Anterior column and posterior hemitransverse acetabular fractures, which are complex fractures, are relatively rare, compared to other acetabular fractures. For the associated anterior column or wall posterior hemitransverse fractures, the anterior fracture line typically passes higher either horizontal (anterior column) or oblique (anterior wall) plane. Posterior column fracture line which is in the transverse plane can be found anywhere. This type of fracture may have a different radiological appearance and it is difficult sometimes to differentiate them from T-type or both column fractures. Non-surgical management may be performed for non-displaced fractures or minimally displaced fractures (<2 mm of displacement) and for the patients with stable and congruent hip joint without any evidence of subluxation. Open reduction and internal fixation should be considered for all displaced acetabular fractures which are inconsistent with the criteria of conservative treatment.