A fracture of the coracoid process associated with an acromioclavicle joint separation is an extremely uncommon injury. The fracture is often quite subtle and could be overlooked or misdiagnosed as an unfused epiphysis. Only 35 cases had been reported in the literature. A 35-year-old woman sustained a direct trauma to her left shoulder in a motorcycle accident with this type of injury is presented. Open reduction and internal fixation of the acromioclaviclar joint were performed and resulted in an excellent outcome in this case. The 35 casesreported in the literature were also reviewed.