The lateral offset acetabular component, a reconstruction technique for hips with acetabular bone loss, causes a torsional moment because of the displacement of the center of hip rotation and may increase the risk of fixation failure. Eighteen patients who had an acetabular revision with a 7-mm offset cementless component were retrospectively studied to identify factors that influence outcome and to clarify indications for its use. The average follow-up time was 47 months and all patients were followed up for a minimum of 2 years or until the failure of the fixation. At the latest follow-up examination, 3 of the 18 cups had been revised for loosening, 1 cup had radiographic loosening, and 1 patient was considered a clinical failure. Clinical or radiographic failure was significantly more likely (P < .05) in patients with a higher shell abduction angle. On the basis of the definitive failures in more than one fourth of reconstructions at early follow-up, the routine use of this component is not recommended in revision surgery with acetabular deficiency.