Short term results of cemented acetabular reconstruction with the use of the Mueller reinforcement ring in 30 hips in 29 patients have been reported previously. The indications for reinforcement were primary and postrevision segmental, cavitary, and combined acetabular deficiencies. The current study reports the medium term clinical and radiologic results of 26 of the 29 patients who were surgically treated (18 primary and eight postrevision hips) and who underwent followup with detailed clinical and radiographic analysis within an average of 9 years (range, 7–12 years). In the latest followup, there has been a statistically insignificant decrease in clinical scores compared with those obtained immediately after surgery; the changes probably are a result of the patients' aging. The radiologic scores at the latest followup were lower, although not statistically significant, than those at the short term followup. The causes of the three ring failures that occurred 5, 8, and 8.5 years after surgery and required revision arthroplasty were either acute trauma or tuberculous arthritis. Three additional hips (two primary and one revision) had evidence of loosening in the ring and socket associated with symptomatology and were considered as hips with impending revision. The rate of success of primary implantation was 94% at 7 years, 86% at 10 years, and 86% at 12 years and was not statistically different from that of revision implantation, which was 86% in all three followup periods. In this small series this surgical technique was successful and effective and followed by good medium term clinical and radiographic results in primary and revision implantation in segmental, cavitary, or complex acetabular deficiencies and in osteoporotic or deficient acetabular bone.