Abstract: [Object] To observe the clinical efficacy and safety of two-row rivet fixation technique and anatomical plate internal fixation for the treatment of comminuted humeral large tuberosity fractures. [Method] A retrospective analysis of 38 cases of comminuted fracture of greater tuberosity humerus admitted from April 2014 to December 2017 was performed. 17 cases (rivet group) were treated with two-row rivet fixation technique, and 21 cases (steel plate group) were treated with open reduction and anatomical plate internal fixation, the differences of operation time, intraoperative blood loss, surgical incision and shoulder joint function between the two groups were compared. [Result] Both groups were followed up for 12-30 months with an average of 17.84±4.40 months. There were significant differences in the operation time, intraoperative blood loss and surgical incision between the two groups (P<0.05). There was no significant difference in fracture healing time between the two groups (P>0.05). The Neer score of shoulder function, shoulder joint activity of lift and outer spin, VAS and Constant—Murley score were not significant difference(P<0.05). [Conclusion] Compared with anatomical plate internal fixation, two-row rivet fixation technique can reduce surgical trauma and hospitalization costs, and avoid secondary removal. In the case of strict control the operative indications, it is commended that preference for using two-row rivet fixation technique to treat comminuted fracture of greater tuberosity humerus.