Abstract Purpose: To evaluate the results of 15 patients following arthroscopically assisted AC joint fixation using cortical fixation buttons (AC tightrope or dog bone fiber tape construct) for acute AC joint separations. Patients and Methods: Patients with acute AC joint injuries (Rockwood grades III–V) of less than 3 weeks duration were included in the study. We had 15 cases of AC joint injuries, which fulfilled the inclusion criteria. All patients were diagnosed based on history, examination and plain radiographs. Patients with grades III–V were selected for arthroscopic assisted fixation using cortical fixation buttons (AC tightrope or dog bone fiber tape construct or double endobutton, Zip Tight). Functional outcome of patients was assessed using constant shoulder score, Quick DASH score preoperatively and postoperatively. Results: VAS for pain in 80% of patients there was a minimal pain VAS score of (0-2). Mean post-operative constant score at one year was 92.33. The Quick DASH subjective functional disability score was ≤ 10 in 75% of patients. The difference in Coracoclavicular distance between the injured and uninjured sides showed a significant improvement in mean values between the preoperative and 1-year evaluations (9.3 mm and 2 mm, respectively; p < 10–6). All patients had satisfactory outcome. We reported only one case of coracoid fracture, which was the 2nd case operated due to improper exposure of coracoid base & was fixed with hook plate. Conclusion: Arthroscopic fixation using the cortical fixation buttons (AC Tightrope or dog bone fiber tape construct) for acute AC joint dislocation achieves satisfactory outcome.