Objective To explore the diagnosis and treatment of marginal compression fractures of acetabular posterior wall with posterior dislocation of hip. Methods Eleven patients with marginal compression fractures of acetabular posterior wall and posterior dislocation of hip were retrospectively reviewed. Their conditions were all confirmed by CT scan before operation. AH the patients were treated by ORIF (open reduction with internal fixation) and the compressed bones were elevated with bone grafts. All the fractures were fixed with reconstruction plating. Results The mean follow up was 32. 4 months (5 to 56 months) . The results of modified d'Aubigne and Postel score system were excellent in four patients, good in four, fair in two, and poor in one. The good to excellent rate was 72. 7%. Conclusion It is likely for patients with fractures of acetabular posterior wall and posterior dislocation of hip to have marginal compression fracture which can be definitely diagnosed by CT scan preoperatively. Good results can be obtained by elevating part of the compressed marginal bone with bone grafting, because it can improve the reduction of acetabulum and femoral head.