As the incidence of primary and revision hip arthroplasty increases, the need for a comprehensive approach to acetabular revision cannot be overstated. In the presence of osteolysis, there is a substantial population of patients with a well-fixed acetabular shell. It will be helpful to orthopaedic surgeons to review the classification of acetabular defects, techniques for exposing an acetabular component when the femoral component will be retained, methods of facilitating access to osteolytic lesions, the principles of bone grafting, options for liner fixation, and when removal of a well-fixed shell is necessary.