Purpose the study - despite of this fact that there are different surgical techniques to treat acromioclavicular dislocation and also the surgery remains controversial, the purpose of our study is to compare the results of surgery treatment to acromioclavicular joint dislocation on the condition of surgical method: Hook Plate versus TightRope. Between 2015 and 2019, 30 patients were with acute Rockwood type III-VI acromioclavicular dislocation at the age of 23-54. Patients were divided into 2 groups according to the surgical methods (Hook plate: n=15; TightRope: n=15)to compare the functional outcome after using either Hook plate and TightRope stabilization. Patients were evaluated using Constant Score and radiography. Comparing the functional results, were observed some differences between the two groups. According to Constant Score the results were: Hook plate - 78.5, TightRope - 81.4. 14 patients in the hook plate group were reoperated to remove the device, except 1 patient who refused to be reoperated. There was insignificant difference between both groups regarding severity pain. The majority of tightrope group (70%) regained their normal functional activities, whereas only 40% of the hook plate patients did (р<0.001)/ About half (50%) of the tightrope group in comparison with 30% of hook plate group had active forward flexion more than 150° (р<0.01). Both groups showed no significant differences regarding degree of muscle strength, patients' satisfaction, and total outcome. Both operative methods are effective techniques and could be recommended to treat an acute acromioclavicular joint dislocation. Between the two groups are no significant differences. However, TightRope fixation provides a low rate of failure and complications and avoids the need for second surgery to remove the implant.