A patient-specific acetabular guide can be used for preparing an acetabulum of a patient to receive an acetabular implant. The acetabular guide includes a patient-specific engagement surface designed to be complementary and mateable with a corresponding surface of the patients pelvic anatomy. The acetabular guide is designed during a pre-operative plan for the patient by a three-dimensional reconstruction of the anatomy of the patient using two-dimensional medical images. The patient-specific engagement surface has a first portion mateable with a portion of the acetabulum of the patient. The acetabular guide includes a guiding element that extends from the acetabular guide opposite to the first portion of engagement surface. The guiding element defines a bore designed to be oriented along an alignment axis for an acetabular implant when the acetabular guide is engaged to the acetabulum.
