For pelvic fractures, pre- and postoperative imaging includes spiral computed tomography, providing high resolution and accuracy. In conventional pelvic operations, these image data cannot be used directly. Intraoperative imaging is limited with fluoroscopy and visualization by the approaches. One solution in terms of precision and reduction of radiation exposure could be computer-assisted surgery (CAS). This method can be divided into navigation, which requires active registration, CT based navigation and registration-free fluoroscopy-based or Iso-C-3D-based navigation. Applications for CAS in the pelvis include sacroiliac screw osteosynthesis in pelvic ring fractures, navigated periacetabular screw fixation, and correction operations for malhealed pelvic ring fractures. Nowadays, CAS is still costly and frequently requires additional staff. However, it helps to reduce complications caused by implant placement. With the introduction of new health care requirements in Germany, this may be an economic argument as well. Current developments focusing on accurate navigated reduction will provide new indications for CAS, further decrease complication rates, and help to reduce the invasiveness of pelvis operations.