Background: Acromioclavicular (AC) joint separation/dislocation represents widely recognized as shoulder injuries seen in general orthopedic. The recent biomechanical study of the AC joint made a lot of changes in the Treatment modalities of the joint. Objective: our aim is to report the clinical outcome of management of acute acromioclavicular (AC) joint dislocation type III and V by clavicular hook plate with direct coracoclavicular ligament repair. Patients and Method: A prospective study including thirty Four patients with AC joint dislocation type III and V Rockwood classification was conducted from June 2014 to October 2018 in our University Hospitals. Patients were treated by open reduction of the dislocated AC joint and internal fixation by clavicular hook plate together with direct repair of the coracoclavicular (CC) ligament. Three patients lost during follow up and operation one patient died during follow up from cardiac problem before the surgery. The patients were evaluated by plain radiography for AC joint stability and functionally by Constant–Murley Score. Results: Thirty patients with 22 patients (73.3%) were male and eight patients (24.7%) were female. The mean follow-up period was 24±4.3 months (range 18-32 months). The mean age was 30±4.5 years (range 20- 43 years). The operative time of our procedure was of a mean of 42±2.4 minutes (range 34-59). All the patients had the plate removed after the third month postoperatively the mean 102±3.4 days (range 89-125). Follow-up radiograph after plate removal showed maintained reduction of AC joint in 28 patients. In the other two patients, loss of reduction of 1–2mm was noticed. The mean Constant–Murley score in the last follow-up was 93±5.6 (range 85-99). Conclusion: A good functional outcome and low complication rate was reported with the used our approach in comparison with other operative procedures.