Bachground: Total hip replacement (THR) after acetabular fracture is a complex procedure and presents the surgeon with unique challenges. THR maybe indicated in two distinct clinical scenarios; firstly, if an acute acetabular fracture would result in a predictably poor outcome if treated with open reduction and internal fixation (ORIF), and secondly (and most commonly) after a patient develops post-traumatic arthritis after either non-operative or operative treatment of an acetabular fracture. Purpose: Purpose of this article wad to assess the outcome of total hip replacement in the management of selected acetabular fractures among adult with traumatic hip arthritis.  Methods: Prospective and retrospective studies of 494 patients who underwent primary total hip arthroplasty for acute Acetabular fractures. The study was done in different places. Collected during the period from 1990 to Jan 2015. Results: in our series of primary total hip replacement for acute acetabular fractures we had excellent/good results. Mean Harris Hip Score = 82.5. Conclusion: primary total hip replacement is a reasonable method of treatment of selected acetabular fractures and good method for treatment neglected acetabular fracture. Outcomes may not be as good as total hip replacement done for other conditions.