The aim of this article is to propose a diagnostic and therapeutic algorithm for the acetabular periprosthetic fractures.This article explores the current literature on the epidemiology, causes and classification of periprosthetic acetabular fractures. Integrating data with the experience of the authors, it offers a guide to diagnosis and possible therapeutic strategies.Intra-operative fractures can occur during rasping, reaming or implant impaction, and they must be treated immediately if the component(s) is (are) unstable. Post-operative fractures can be due to major trauma (acute fractures) or minor forces in bone osteolysis; it is possible to plan reconstruction and fixation according to fracture characteristics. Treatment choice depends upon fracture site and implant stability.Periprosthetic acetabular fractures are uncommon complications that can occur intra-operatively or post-operatively, and a reconstructive surgeon must be able to manage the procedure. Accurate planning and reconstruction implant are necessary to achieve good cup stability.