The modified Gibson surgical exposure of the acetabulum is a useful alternative to the Kocher-Langenbeck approach. The advantages of the modified Gibson posterior approach over the Kocher-Langenbeck include increased anterosuperior direct access to the innominate bone and decreased risk of iatrogenic injury to the nerve supply to the gluteus maximus muscle as well as minimizing the need for trochanteric osteotomy. This approach can be used in almost any situation that would otherwise call for the Kocher-Langenbeck such as the surgical treatment of posterior wall, posterior column, and selected transverse and T-shaped fracture types.