Pelvic osteotomy is a powerful tool for improving the mechanical forces in a dysplastic hip. Multiple techniques have evolved over the past 70 years to treat the symptomatic adult patient with acetabular dysplasia. Although the Bernese periacetabular osteotomy is commonly used in the United States, several other types of osteotomies, including the rotational (spheric or dial) acetabular osteotomy, the triple pelvic osteotomy, and the Chiari medial displacement pelvic osteotomy, have demonstrated good success and are used in many parts of the world.