Objective To evaluate the effect of reconstruction withautograft implantation in total hip arthroplasty(THA) with regional acetabular deficiency. Methods From 1991 to 2000, 39 cases of THA with acetabular deficiency were conducted. Autogenous bone implantation was used to reconstruct the deficient acetabulum. Of the 39 patients, 25 were males and 14 were females. The age ranged from 34 to 62(45.2 on average). There were21 cases of developmental dysplasia resulted deficiency, 14 cases of fracture of femoral neck complicated with head necrosis(10 hips) and fracture of acetabulum(4 hips). The resected femoral heads or autologous ilium were made the wedgeshaped graft and implanted into the deficient acetabulum, which included 12 cases with cement THA and 27 with cementless THA.Of all the cases, 24 were followed up 2 to 10 years(6.7 years on average). Harris scores before operation were 18 to 50(38.1 on average). Results The limbs were lengthened by 2.4 cm on average. No serious complications were observed in these patients. Comparedwith the scores before the operation, the average Harris scores after the operation were 92.1(Plt;0.01)and 86.3(Plt;0.05) in the one-year and the latest follow-up respectively. The rates for the good were 91.7% and 83.3% in the one-year and the latest follow-up respectively.Conclusion The acetabular reconstruction with autograft in THA will bring better stability in those patients with acetabular deficiency. It is of significance in maintaining a long-term function in the replaced hip.