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Introduction: Acetabular bone loss represents a great challenge during hip arthroplasty procedures. This study aims at evaluating the efficacy and functional outcome of cost-friendly alternatives (autograft or allograft) when compared to the porous metal augments during reconstruction of acetabular defects in either complex primary or revision total hip replacement. Patients and Methods: This is a retrospective matched control study for evaluation of short and midterm results of metal augments versus bone graft during hip arthroplasty procedures. Inclusion criteria included adult patients who suffered from segmental acetabular defect and underwent hip arthroplasty procedure. The study included 34 cases divided into 2 groups. Group 1 cases were reconstructed with augment reconstruction. Group 2 was the control group which was reconstructed using graft reconstruction. Results: The mean age for Group 1 was 52.29 years (range: 30–68) and for Group 2 was 52.1 years, (range from 32 to 71 years). The mean follow-up period was 74.8 months in Group 1 (range: 66–85 months) and 71.5 months in Group 2 (range: 60–102 months). Both the groups included 13 males and 4 females. Group 1 had a mean postoperative Harris Hip Score (HHS) of 90.5 (range from 85 to 94), and Group 2 had a mean postoperative HHS of 88.7 (range from 80 to 94) with P = 0.236. Conclusion: Acetabular reconstruction using cost-friendly alternatives shows similar short-to-midterm results when compared to trabecular metal augments in a budget-conscious health setting. [ABSTRACT FROM AUTHOR]