Purpose: To determine whether combined acromioclavicular (AC) ligament reconstruction and coracoclavicular (CC) ligament reconstruction without bone tunnels would improve radiographic reduction maintenance and complication rates for type III to V AC dislocations. Methods: This single-institution retrospective study analyzed all patients who underwent a hybrid synthetic/graft wrap CC reconstruction without tunnels with additional AC reconstruction/repair from January 2013 to August 2019. This 26-patient cohort was compared with a 1:1 sex-and age-matched control group who underwent CC reconstruction without AC reconstruction. CC distances on postoperative radiographs were compared with normal contralateral shoulders. Results: Of the 93 patients who underwent AC reconstructive surgery during this time period, 26 patients (96% male) met the inclusion criteria. The AC/CC cohort had 23.5% type III injuries, 23.1% type IV injuries, and 53.8% type V injuries, similar to the control group. Final radiographs of the operative shoulder's CC distance were (mean AE standard deviation) 0.9 AE 4.0 mm greater than that of the contralateral shoulder (9.6 AE 8.7 mm) in the AC/ CC cohort. Final radiographs of the operative shoulder's coracoclavicular distance were 4.0 AE 4.7 mm greater than that of the contralateral shoulder (13.3 AE 9.3 mm) in the CC control group, a significant difference (P ¼ .014). The AC/CC reconstruction group had fewer patients with a loss of reduction >5 mm (11.5% versus 38.5%, P ¼ .025). The complication rate in the CC control group was higher than in the AC/CC cohort (30.7% versus 7.7%, P ¼ .035). The reoperation rate was also greater in the CC control group (8 versus 1, P ¼ .010). Conclusion: This cohort study shows that the addition of AC reconstruction to CC reconstruction using synthetic tapes/grafts or allograft tissues without bone tunnels significantly improves durable radiographic outcomes, diminishes complication rates, and improves reoperation rates. Level of Evidence: III, retrospective comparative study.S cromioclavicular (AC) dislocation continues to confound the orthopedic community as a notoriously difficult injury to treat with or without surgery.The Rockwood classification remains central to communication and treatment determination regarding this injury. Type I, II, and often III injuries are managed conservatively, and type IV, V, and VI injuries (with some type III injuries) are mostly managed operatively. 1 Controversy continues for all aspects of care, including operative versus nonoperative decisions, surgical timing and technique, rehabilitation and return to sport, need for concomitant surgery, etc.