Patients with acetabular (AF) and pelvic ring fractures (BrF) make heavy demands on hospital resources and face difficulties in rehabilitation. From the patients' point of view, milestones in recovery are quality of life and return to productivity. We studied 42 patients with acetabular and 64 patients with pelvic ring fractures over a period of 10 years. The average follow-up took place 4 years after discharge. The injury severity score (ISS) did not correlate to long-term disability and quality of life (QoL) based on the Rosser index, data on return to productivity, or to radiological and clinical outcome. This study emphasizes the need for new injury scoring systems that better predict the recovery and ability to return to work of trauma patients after surviving pelvic fractures. Proper follow-up evaluations should analyze the patients' quality of life and working activity beside traditional items such as radiological and clinical findings.