Thorough assessment and classification of acetabular and pelvic fractures through plain X-ray and computed tomographic images as well as selection of an appropriate surgical approach and application of the surgical reduction successfully are the major components of a successful management plan. In recent years, surgical treatment methods have become widespread. The ideal treatment of severely displaced acetabular fractures, in particular is surgery with anatomical reduction. Anatomical reduction of fractures may result in significantly reduced long-term complication rate. The major limitations of surgery include the selection of the surgical approach and operation of the fracture effectively. No single approach is best for all types of fractures. In the majority of the cases, Pfannenstiel, ilioinguinal and Kocher-Langenbeck approach have been widely adopted as eminent approaches, due to their low morbidity rate. An extended approach such as extended iliofemoral approach to the aceutabulum or pelvis should be avoided in the presence of complex fractures, old fractures and malunion, the major contributing factors to complicated reduction surgery. Surgical treatment of pelvic and acetabular fractures is not a usual and routine surgical procedure for general orthopaedic surgeons. Therefore, a long learning curve and comprehensive training program with significant experience are required for surgical treatment of these fractures.