Background:Proximal humerus fractures are one of the commonest fractures occurring in the skeleton. They account for approximately 4 – 5% of the all fracture. The incidence of fracture of the proximal humerus is bimodal in geriatric due to osteoporosis and in adolescents due to highenergy trauma. A conservative treatment in a sling followed by functional rehabilitation under supervision yields satisfactory results in minimally displaced fractures. The proximal humerus is adapted to allow for the large range of motion of the shoulder joint. The proximal humerus consists of the humeral head, the greater, lesser tuberosities, and shaft. The region of transition between the articular cartilage and surrounding bone is defined as the anatomic neck and serves as the site of attachment of the articular capsule, whereas the region immediately inferior to the tuberosities is termed the surgical neck. The incidence of proximal humerus fractures is increasing, especially in the elderly. Proximal humeral fractures account for 4% to 5% of all fractures in adults and less than 1% of children's fractures. Approximately 3% of physeal fractures occur through the proximal humerus.Operative management can consist of closed reduction and percutaneous fixation, suture fixation, operative fixation with plate and screw construct, or intramedullary fixation. The goals of operative fixation are to restore the anatomy of the proximal humerus to allow for successful union, maximize function and early rehabilitation.The articular surface’s relationship to the shaft must be restored to maximize range of motion as well as stability. The tuberosities must also be reduced to their anatomical position especially Isolated fractures of the greater tuberosity may be managed surgically even with less displacement to maximize function of the arm by re-establishing the insertions of the rotator cuff.