[Objective] To investigate the postoperative complications and their management strategies of hook plate fixation of acro- mioclavicular dislocation. [Methods] A retrospective study was performed on 105 patients who received clavicular hook plate fixation for acute acromioclavicular dislocation from January 2011 to January 2021. The clinical results and complications were evaluated. [Results] All 105 cases were successfully operated on without serious complications such as vascular and nerve injury. During the follow-up, 97 pa- tients of them had significant limitation of shoulder movement and pain during movement, and had the hook plate removed from 10 to 20 months with a mean of (12.3±5.3) months. In the hook plate removal, 12 cases underwent arthroscopic examination simutaneously, which re- vealed subacromial synovitis in 2 cases, subacromial impingement in 2 cases, and subacromial surface abrasion in 8 cases. Compared with 3 months after surgery, the VAS score, Constant-Murley score, forward flexion-lifting range of motion (ROM) , and abduction-lifting ROM on the affected side were significantly improved at the last follow-up (P＜0.05) . However, the involved side proved significantly inferior to the health side in terms of VAS and Constant-Murley scores, as well as ROMs at the corresponding time points (P＜0.05) . Radiographical- ly, of the 105 patients 98 patients had adverse imaging findings accounting for 84.8%. The incidence was ranked from high to low as fol- lows: acromioclavicular bone wear 86/105 (81.9% ) , acromioclavicular impingement 15/105 (14.3% ) , acromioclavicular arthritis 6/105 (5.7%) , acromioclavicular subluxation downward 6/105 (5.7%) , plate dislocation or anterior acromioclavicular subluxation 4/105 (3.8%) . There was no significant difference in the incidence of all types of adverse imaging findings (P=0.242) . [Conclusion] The hook plate inter- nal fixation for acromioclavicular dislocation has considerably high complication occurrence, should avoid being used for acromioclavicular dislocation caused by coracoclavicular ligament rupture as far as possible.