The ilioinguinal approach is one of the commonly used and widely accepted as an outstanding approach in the surgical treatment of severely displaced acetabular fractures. This technique was originally described by Letournel in 1960. The main merits of this approach include rapid recovery period and reasonably low complication rate. In recent years, it has been adopted widespread for the treatment of aceutabular fractures. However, anatomical structures of the fracture zone may complicate surgery. The fractures involving the anterior part of the acetabulum, such as anterior column and/or wall fractures, anterior column plus hemitransverse fractures of the posterior column and certain transverse fractures can be reduced and fixed through the ilioinguinal approach. Some T-type fractures involving more displacement in the anterior column of the fracture can be also treated using ilioinguinal approach. In this article, reduction techniques through the ilioinguinal approach in the treatment of acetuabular fractures and pearls and pitfalls were presented.