To evaluate the efficacy and the complication rates of the ilioinguinal approach for satisfactory reduction in complex acetabular fracture except for poserior wall or column fractures, twenty consecutive patients undergoing ilioinguinal approach for open reduction with internal fixation of acute, displaced fracture(3/89-10/93) were reviewed. There were six elementary and fourteen associated fracture patterns. Two among them were open fractures. Fifteen were male and five female with a mean age of forty-four years. three patients those associated with a comminuted quadrilateral plate required to buttress the medial wall with a spring plate modified from a one-third tubular plate as a part of reconstruction plates assembly. Indirect reduction of the involved and opposite column was achieved mainly with lateral traction through the great trochanter. Two patients with associated fracture pattern needed to undergo combined anterior and posterior approach. A satisfactory reduction(concentric, gap<3mm, step-off<2mm) was obtained 85% of the cases. There were four kinds of perioperative complications: transient sciatic nerve palsy(one after double incision), hematoma(one), loss of fixation(one), lateral cutaneous nerve of thigh injury(two). There were no infections and functionally significant heterotropic ossification. In conclusion, the morbidity of an extended surgical approach previously recommended for complex acetabular fractures can be avoided.