How to do a good periacetabular osteotomy? The periacetabular osteotomy can effectively improve the acetabular coverage, increase the weight-bearing joint surface and shift the center of rotation of the hip joint, thus reducing the cartilage stress on the weight-bearing surface of the hip joint and preventing and delaying the occurrence of osteoarthritis. Since the application of periacetabular osteotomy for the treatment of adult hip dysplasia, good clinical efficacy has been achieved and the procedure has been widely recognized and applied. Emphasis on the procedural and meticulous operation and perioperative management of the Bernese periacetabular osteotomy will help to reduce the incidence of surgery-related complications and improve the long-term prognosis of patients. However, it is not easy to perform a successful surgery. As the saying goes, a minute on the stage is a decade of work off the stage. Surgery is the same way. It requires a strategic vision and a tactical approach. Strategic vision – off-stage work: understanding of joint deformity pathology and biomechanics, mastery of surgical indications, design and selection of surgical plan, and perioperative management plan. Tactical means – the means on the stage: precise osteotomy, optimal correction, and process-oriented operation. Perioperative prognosis includes: analysis of the problems, whether the operation can be resolved, choice of surgical plan, whether blood transfusion is needed, management of postoperative pain, methods of postoperative rehabilitation, etc. Surgical procedures that may be required: periacetabular osteotomy, hip surgical dislocation joint cleaning and glenoid lip revision, femoral head deformity management, and proximal femoral deformity management. Intraoperative quality control: precise pelvic osteotomy, optimal acetabular position correction.