To investigate the CT staging of hip dysplasia in adults to guide the surgical operation of artificial total hip replacement. [Methods] Sixty-three Crowe I patients with acetabular dysplasia with severe osteoarthritis or femoral neck fracture were admitted, and 10 cases of double hip replacement were performed. Preoperative X-ray and 3D CT were routinely performed to clarify the diagnosis and the presence and extent of deformity on the acetabular and femoral sides and to perform staging, and the surgical plan was reasonably designed according to the new staging. Postoperative and follow-up X-rays were performed to evaluate the position of the prosthesis, whether there was displacement, loosening, periprosthetic fracture and limb length. [Results] At a mean follow-up of 3.3 years, there was no incision or deep infection, no periprosthetic fracture and no nerve injury after surgery, and the Harris score improved from (37.9±6.9) before replacement to (91.2±2.8) recently after surgery in all patients. Except for 2 early cases (2.7% of the total) who underwent second-stage revision due to postoperative dislocation; the remaining 71 cases (97.3%) had good integration of the femoral stalk and acetabular cup position and matching with the surrounding bone on X-ray after long-term follow-up. Among the 63 patients, 37 limbs were unequal before surgery and 34 were equal after surgery, with shortening <1 cm in 3 cases. [Conclusion] For patients with acetabular dysplasia, the new CT staging, which can better manage the deformity of the acetabulum and proximal femur, guides the selection of an appropriate prosthesis and obtains ideal postoperative function.