Introduction: Posterior hip dislocation of the hip with acetabular fracture is a challenging problem to treat. Such dislocations are associated with avascular necrosis of the femoral head if neglected. Managing such conditions with total hip replacement (THR) is very difficult because of associated altered anatomy. Case Presentation: We hereby report a two-year neglected hip dislocation with associated acetabular fracture successfully treated with uncemented THR. The patient was successfully treated with uncemented THR and experienced significant improvement in his functional status, with a Harris hip score of 82 at the two-year follow up. Radiologically, there were no radiolucent areas or osteolysis, with good consolidation of the bone graft. Conclusions: A neglected hip dislocation with acetabular fracture can be managed satisfactorily with uncemented THR. Bone reconstruction using chunk grafts and use of cementless components ensures long-term survival and also preserves adequate bone stock for revision, especially in young patients.