Acetabular dysplasia refers to poor coverage of the femoral head by the acetabulum, shallowing of the acetabulum, and outward displacement of the hip joint center due to defective acetabular development during development. As the acetabulum and the femoral joint do not fit together properly, the contact stress on the joint surface is increased and the articular cartilage degenerates, causing osteoarthritis. This disease sometimes starts with knee pain instead of hip pain, and hip pain occurs only when the disease is advanced, which is the reason why it is easily missed or misdiagnosed. The treatment of acetabular dysplasia aims to correct the deformity of the acetabulum, restore the coverage of the acetabular hyaline cartilage, increase the weight-bearing area of the hip joint, rebuild the normal biomechanical relationship of the hip joint, and reduce the occurrence and development of osteoarthritis. Depending on the degree of acetabular dysplasia deformity, the surgery can be divided into two types: reconstructive osteotomy and salvage osteotomy. Reconstructive osteotomy is used in the early stages of osteoarthritis to restore a near-normal anatomical relationship and hyaline cartilage coverage to the hip joint. If the osteoarthritis is close to the advanced stage, only salvage osteotomy or artificial joint replacement can be chosen. The current reconstructive procedures for adult acetabular dysplasia are acetabular rotational osteotomy and periacetabular osteotomy, both of which can achieve excellent clinical results. The representative surgery of salvage pelvic osteotomy is the acetabular rotational osteotomy carried out in our department, which improves the acetabular accommodation of the femoral head through acetabular osteotomy and rotation, thus reducing contact stress, relieving painful symptoms, stabilizing the joint, improving gait, delaying the time of artificial joint replacement, and providing good acetabular coverage for future artificial joint replacement. For patients with acetabular dysplasia combined with advanced osteoarthritis, total hip replacement is currently the only method with proven efficacy.