In revision total hip arthroplasty (rTHA), the use of structural allografts in the reconstruction of large acetabular defects has become increasingly less common with the advent of improved acetabular implant design and porous metal augments. Structural allografts may still be useful in restoring bone stock in younger patients at a higher risk of subsequent injury and can provide good outcomes when utilized under the right circumstances with good techniques. This chapter explores the indications for, approach to, and postoperative management and outcomes of structural allografts for very large acetabular defects.