Acromioclavicular dislocation with a concomitant coracoid process fracture occurs infrequently, as only several cases have been reported in the literature. This injury usually occurs in the second or third decade of life. The mechanism of injury were sports, motor vehicle and direct trauma. An axillary lateral radiograph of the shoulder often is needed to detect this fracture. The authors present two cases of coracoid process fracture associated with acromioclavicular dislocation. Satisfactory function with minimal residual cosmetic deformity may be achieved by nonoperative measures. Also surgical treatment can produce good result in complete third acromioclavicular separation combined with the significantly displaced coracoid fracture.