Acromioclavicular (AC) separation injuries are common and are typically described with the Rockwood classification system. Severity of injury ranges from ligamentous sprain to partial tear to complete tear with displacement of the distal clavicle. Physical examination reveals tenderness upon palpation of the AC joint, as well as a visual step off lateral to the joint in more severe injuries. Less severe injuries are treated conservatively with a sling, analgesia, and physical therapy. Severe injuries should be referred to an orthopedic surgeon for consideration for operative management.