Seven adult patients with acetabular fractures were investigated with conventional X-rays, axial spiral computed tomographic (CT) images and three-dimensional (3D) surface rendered reconstructions. Spiral CT has the advantage that it acquires the data much faster than incremental CT, resulting in less motion artefacts. A semi-automatic three-dimensional environment for segmentation has been developed in our institution. It created significant reduction of user interaction and improved visualization of acetabular and femoral joint surfaces. The main advantages of three-dimensional visualization of acetabular fractures included: creation of unlimited and unique views by which fracture location, fracture extension, fragment shape and fragment position became more clear, better visualization of acetabular dome and quadrilateral plate and more simple and easier interpretation of these complex fracture patterns. On the other hand, 3D surface reconstructions do not accurately demonstrate undisplaced fractures, intra-articular fragments may be obscured, congruence assessment is uneasy, and soft tissue injuries are not shown. Therefore, we consider 3D images of acetabular fractures as being complementary to and not a substitute to plain radiographs and axial CT scans.