The treatment of benign pelvic lesions and tumors is still a challenge in clinical orthopedics. The surgical procedure was complicated and the postoperative complication was hard to avoid usually. The purpose of this study is to analyze the clinical outcome and predict the fracture risk of benign bone tumors on acetabular dome by finite element analysis. In our research, clinical data of 25 patients were collected from January 2010 to January 2017, including basic information of patients, reconstruction methods, complications, and postoperative MSTS function scores. Finite element analysis (FEA) was used to predict the fracture risk when a benign tumor involved an acetabular dome. 25 patients were followed up for 37.5 ± 5.6 (ranging from 24 to 78) months. Intraoperative bleeding was 100-3000 ml (mean 858.3 ml). The postoperative MSTS93 score was 19.61 ± 7.32 before operation and 26.28 ± 15.59 at the last follow-up. The results of finite element analysis suggest that there was a high risk for pathological fracture in the following: both columns were damaged by tumors; the anterior column and 50% of the posterior column were affected. Other cases were in the low fracture risk group. Based on this study, we believe that, according to the risk assessment results of tumor cavity fracture suggested by the FEA results, combined with the nature of tumor, it may become a useful tool which is a great significance to guide the operation plan, select the operation time, and guide the postoperative functional exercise.Copyright © 2022 Hongsheng Yang et al.