Current acetabulum fracture management represents a complex interplay of surgical and non-surgical approaches tailored to the unique characteristics of each injury. The initial assessment hinges on a thorough clinical examination, complemented by advanced imaging techniques such as CT scans, enabling precise fracture classification according to established systems like the Judet and Letournel classification. This detailed assessment guides treatment strategy, considering factors such as fracture displacement, patient age, comorbidities, and functional demands. Non-operative management, primarily indicated for minimally displaced fractures in select patients, often involves strict weight bearing restrictions and rigorous physical therapy. However, the majority of acetabulum fractures require surgical intervention to achieve anatomical reduction and stable fixation. Surgical techniques have evolved significantly, with a shift towards minimally invasive approaches whenever feasible. These include open reduction and internal fixation (ORIF) using a variety of implants, including screws, plates, and cannulated screws, chosen based on fracture morphology and location. The aim is to restore articular congruity and joint stability while minimizing iatrogenic damage. Recent advancements include the increasing use of computer-assisted navigation and 3D-printed implants, enhancing precision and potentially reducing surgical time and complications. Post-operative management focuses on early mobilization and targeted rehabilitation programs, crucial for optimizing functional outcomes. Challenges remain in managing complex, highly comminuted fractures, and achieving optimal long-term results necessitates meticulous surgical planning, precise execution, and diligent post-operative care. Ongoing research focuses on refining surgical techniques, improving implant designs, and developing novel rehabilitation strategies to further enhance patient outcomes and reduce the incidence of complications such as post-traumatic arthritis and avascular necrosis. The field continues to evolve, striving for improved functional recovery and a higher quality of life for patients with acetabulum fractures.