We report a patient with severe intrapelvic migration of the acetabular component after total hip arthroplasty. Preoperative drip infusion pyelography showed a medial shift in the ureter caused by the migrated acetabular component. Preoperative angiography showed that the right external iliac artery was compressed and shifted medially by the migrated acetabular component. At revision surgery, the migrated acetabular component was successfully removed through a transabdominal (transperitoneal) approach, with the assistance of a general surgeon, and reconstruction was performed through a transtrochanteric approach. We concluded that the transabdominal approach was a useful approach for removing a severely migrated acetabular component.