Objective To investigate the method and efficacy of acetabular bone defect reconstruction in revision surgery after total hip arthroplasty (THA). Methods A retrospective analysis was performed on 81 patients (84 hips) with acetabular bone defects treated in THA revision surgery, according to the AAOS typing method, type I 7 hips, type II 56 hips, type III 17 hips, and type IV 4 hips. The patients with different types of bone defects were repaired by using large diameter non-cemented prosthetic socket, non-cemented prosthetic socket + cancellous granular implant, cemented prosthetic socket + Cage + cancellous granular implant and cemented prosthetic socket + custom-made prosthesis + cancellous granular implant, respectively. Postoperative follow-up was performed regularly, and the Harris method was used to assess the function of the hip joint and to determine whether there was loosening of the prosthesis and healing of the bone graft according to the radiographs. The mean follow-up period was 45 months (13 to 118 months). The mean postoperative Harris score was 86.2, with an average improvement of 40.6 points compared with the preoperative score. 2 hips required revision due to dislocation, but the rest had good results, with no loosening and sinking of the prosthesis on radiographs, and continuous trabecular bone passing through the graft-host bone junction. Conclusion In THA revision, most acetabular defects can be repaired with larger non-cemented prosthesis or cancellous bone graft; for larger defects affecting the stability of the prosthesis, good results can be obtained with cemented prosthesis socket + Cage + cancellous bone graft; custom-made prosthesis has unique advantages in the management of severe acetabular bone defects.