Periprosthetic fracture is a serious complication of total hip arthroplasty (THA) that can be difficult to treat, and can be potentially fraught with complications. The incidence of such fractures is increasing, especially after the use of cementless revision arthroplasty. The prevention of these fractures is achieved by understanding the risk factors involved. If the risks are not understood, the best outcome is achieved when the surgeon has a thorough understanding of the principles of treatment of these fractures and has access to various fixation and prosthetic devices, and allograft bone when necessary. Acetabular fractures are rare and relatively little has been reported on their treatment. Periprosthetic femoral fracture treatment is based on the site of fracture, implant stability, and bone stock. The Vancouver classification offers a reproducible description of these factors with the subsequently easy formation of a treatment plan.