Objective To investigate the clinical effect of acetabular titanium plate with granulated bone graft in the treatment of severe bone defects in the acetabulum. Methods This technique was applied to treat 27 patients, 6 cases of acetabular bone defect typing (AAOS classification) type I; 4 cases of type IIC; 17 cases of type III, with an average preoperative hip Harris score of 37, and postoperative evaluation according to clinical and X-ray. Results All patients had their acetabulum reconstructed by this method. One case of postoperative prosthesis dislocation was caused by excessive anterior tilting of the reconstructed titanium plate and impingement on the greater trochanter, which was cured by chiseling away part of the trochanter bone to eliminate the impingement factor. In the remaining cases, there were no complications and the average follow-up was 3 years, with a mean Harris score of 87. X-ray showed no translucent bands at the intersection of the acetabular bone bed, graft bone, reconstructed titanium plate and polyethylene lining in any of the patients. Conclusion Acetabular titanium plate with granulated bone graft can effectively repair acetabular bone defects, provide strong initial fixation for the prosthesis, and have the effect of restoring the center of rotation of the hip joint.