The acromioclavicular (AC) joint is a highly used, versatile, and complex joint that provides stability and increases function. Acute and chronic dysfunction at the AC joint can have debilitating effects that should be treated appropriately and expediently to preserve function. The historical, physical examination, and radiographic findings are generally very consistent and lead to both diagnosis and well-established treatment protocols. With few exceptions, injuries can be treated nonoperatively with a high degree of success. When indicated, surgical outcomes are also successful but have an overall higher rate of complications. A physician should be well versed in both acute and chronic conditions to ensure the patient has the best opportunity to reclaim function, return to sport, and avoid pain, restriction in range of motion, and need for further surgery.