60 patients with acetabular fractures were randomized to determine the superior treatment for acetabular fractures. Patients either underwent a classical anterior exposure with the ilioinguinal approach or a modified Stoppa intrapelvic approach. This study suggests that the anterior Ilioinguinal and modified stoppa intrapelvic approaches are comparable in complications, reduction quality, radiographic images and clinical outcomes at 2 years, however, patients who underwent the Illioinguinal approach experienced greater blood loss, increased requirement for transfusion and more wound drainage.