There are few cases in the medical literature documenting intrathoracic glenohumeral fracture-dislocations. A total of eight cases have been reported-two intrathoracic humerus dislocations with greater tuberosity fractures 1, 2 and six cases with intrathoracic fracture-dislocations in which the fracture involved the humeral neck. 3-8 With so few cases, treatment modalities vary, and no guidelines exist. Patients in five of the reported cases underwent surgery, 1, 3-6 while the other three were treated nonoperatively. 2, 7, 8 We present a case of a middle-aged woman involved in a high-speed motor vehicle accident who sustained an intrathoracic humeral head fracture-dislocation and underwent operative treatment.