OBJECTIVE The aim of this study was to evaluate CT- and fluoroscopy-guided percutaneous screw fixation by radiologists in the management of acetabular roof fractures. METHODS Fifty-two consecutive adult patients with a nondisplaced and isolated acetabular roof fracture were prospectively treated by an interventional radiologist who made a percutaneous screw fixation under CT and fluoroscopy guidance. All these procedures were performed under local anesthesia. The postoperative follow-up ranged from 36 to 48 months. RESULTS For each patient, two 6.5-mm Asnis III screws were inserted to fix the roof acetabular fracture. The mean procedure time was 45 minutes (range, 30-90 minutes). No complications were observed. Follow-up CT showed evidence of fracture healing. No evidence of secondary displacement, degenerative changes, or screw failure was noted. Using the rating system of D'Aubigne and Postel, all patients had excellent results. CONCLUSIONS The results of our study showed that nondisplaced acetabular roof fractures could be successfully treated by a minimally invasive technique with an excellent long-term outcome.