INTRODUCTION: Most of the acromio–clavicular injuries result from direct trauma; when an individual lands on the point of the shoulder. Indirect trauma, such as a fall on a flexed elbow or outstretched arm, also may lead to AC joint injury. The AC joint is subcutaneous in nature and thus at high risk for direct trauma. The magnitude of the force determines the severity of injury and the structures involved. If the force is high, the coracoclavicular ligaments and delto–trapezial fascia are involved in the injury. The aim of the study: 1. To determine the outcome of acromio–clavicular injuries seeking service in a tertiary care center. 2. To compare the outcome of type 3 acromio–clavicular injuries treated with conservative and operative methods. MATERIALS AND METHODS: A total of 52 cases identified during study period from 14.11.2018 to 31.03.2019 were included and followed up to 3 months. Rockwood classification was followed to classify these injuries. 4 persons do not came for follow up ; 3 of them were having type 1 injury and 1 had type 2 injury. Among 52, 10 were degenerative subluxation; 15 were type 1 and 12 were type 2 injuries. 4, r type 3 injuries who had given consent were operated and 7 persons who doesn’t give consent treated conservatively. All type 1 and 2 were undergone with conservative line of management. Clinical outcome was assessed by UCLA Shoulder rating scale (University of California at Los Angeles Shoulder Rating Scale). 1 case of degenerative subluxation developed severe pain at the site and treated with excision of lateral end of clavicle and had regained function at 3 months period. On case had associated smith fracture which was treated with open reduction and internal fixation and type 3 AC subluxation was treated conservatively. DISCUSSION: A total of 52 cases excluding 4 lost to follow up were included in the study. The male female ratio was 4:1. The average age is 45 yrs ranges from 23 to 80. A sub set of 12; Type III acromio–clavicular dislocation were separately assessed excluding one case of degenerative one which was excluded from analysis. CONCLUSION: There is no statistical difference between those treated conservatively vs operative at 3 months follow up in Type 3 injuries (p value=0.883). Conservative management of type III acromio–clavicular dislocation gives excellent or good outcome but the cosmetic appearance is not improved by conservative treatment.