The rate of total hip arthroplasty (THA) continues to increase. The incidence of revision total hip arthroplasty will also continue to increase. Revision THAs pose significant challenges to the orthopaedic surgeon. One of the most formidable challenges is the management of major acetabular bone defects in revision THA. There have been many advances in both implant options as well as augmentation capabilities for acetabular defects. This review will focus on some of the newest surgical innovations and techniques in managing major acetabular bone defects.