Poor long-term outcomes after Dewar and Barington technique (1965) in the treatment of acromioclavicular joint (ACJ) dislocation were reported. Its modification by conjoint tendon transfertenodesis may yield stable and anatomic reduction. The purpose of this study is to evaluate the clinical and radiological results of patients with acute high-grade acromioclavicular joint (ACJ) dislocation treated with conjoint tendon transfer -tenodesis. Thirty-two patients were operated in the period between March 2012 and June 2015 and could be recruited and evaluated at the final follow-up. Preoperative documentation of coracoclavicular distance, VAS (visual analogue scale) for pain, ASES (American Shoulder and Elbow Surgeons) score and Constant score was done. Reconstruction was performed using conjoint tendon transfer -tenodesis. Statistical analysis was done using the statistical package for social science (SPSS) program version 20.0. At a median follow-up of 34.4 (range 24.3-60.2) months after the procedure, the coracoclavicular distance decreased significantly from a mean of 21.5 mm preoperatively to a mean of 11.5 mm postoperatively (P < 0.001). The VAS for pain improved significantly from an average of 8.5 points preoperatively to 1.2 at the last follow-up (P < 0.001). Constant score and ASES score improved significantly from 70.69 and 65 preoperatively to 95.25 and 96.4 respectively at the last follow-up (P < 0.001). A deep infection affected one patient. The study concluded that, coracoclavicular ligaments reconstruction by conjoint tendon transfer -tenodesis technique achieves excellent results and could be considered a valid surgical option of management in acute high grade acromioclavicular dislocations.