Background: Acute acromioclavicular (AC)-joint dislocations are common injuries of the shoulder girdle. Surgical repair is indicated for acute high grade (Rockwood types IV, V, and VI) of (AC)-joint injuries. There are many large number of surgical technique that used in treatment of (AC) – joint dislocation. The best surgical technique remains controversial which can group into two groups. The aim of this work was to systematically review the different modalities of surgical management of acute acromio-clavicular joint dislocation. Methods: This systemic review was done using standard methodology outlined in the Cochrane Handbook and reported the findings in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement guidelines.The Cochrane Central Register of controlled trials, PubMed, JBJS, and MEDLINE as database for search. Results: Success rate marked increase in patients underwent anatomical CC reconstruction; compared to other techniques. Failure rate that happened in patients and complications rate marked decrease in patients underwent anatomical technique. The complication that happened in patients are loss of reduction and recurrence of deformity, coracoid fracture, clavicle fracture (some studies come over on this fracture by using single tunnel in clavicle, coracoid or both), infection, adhesive capsulitis, graft failure, clavicular or coracoid osteolysis, hypertrophic distal clavicle, brachial plexopathy, hardware complications (broken hardware and symptomatic hardware), and osteoarthritis of (AC) – joint. Conclusion: This systemic review documented that the anatomic (CC) - ligament reconstruction technique has better than other techniques for the treatment of acute (AC) – joint dislocation & The studies that use (CC) - Fixation by Tight Rope device fixation (by Arthrex) Is less failure rate and complication rate in patients underwent other techniques