Stabilization with arthroscopically applied button-rope suspension systems is the current treatment method that is frequently used in patients with acromioclavicular (AC) injuries. While there are studies reporting that the button-rope suspension system alone is sufficient in acute cases, there are also studies recommending the application of biological coracoclavicular (CC) graft and/or AC horizontal fixation. In chronic cases, CC tendon graft reconstructions are applied in addition to button-rope suspension systems, and horizontal fixation of the AC joint is recommended. The two most common complications in patients who underwent button-rope suspension ± CC ± AC fixation for acute or chronic AC injury are loss of reduction and coracoid fractures, which are interrelated. Reduction loss can be reduced by the application of anatomical CC restorations. In order to reduce the risk of coracoid fracture, it is recommended to open the tunnel to the coracoid in the correct position, with the smallest possible diameter and number of tunnels. In addition, in patients undergoing CC reconstruction with a graft, passing the graft around the coracoid base may reduce the risk of coracoid fracture. Although high complication rates are reported in these treatment methods, generally satisfactory clinical results are obtained. However, the low level of evidence in the majority of studies on arthroscopic AC joint stabilization performed with a small number of patients prevents the establishment of a standard treatment protocol for the treatment of these injuries. Prospective and randomized clinical studies with a large number of patients are needed to obtain more precise results.