Fifty-eight patients with acute acromioclavicular dislocations of Type III, IV and V (Rockwood classification) were examined to assess the late results of conservative treatment. The average age of the patients was 31 years, and the interval between injury and final review was 6.3 years. Seventy-nine percent of the patients had excellent or good late results. Surprisingly the age and activity level of the patients did not influence our late results, nor did the radiological appearance of acromioclavicular osteoarthritis or periarticular calcification. The radiological appearance of the acromioclavicular joint improved in 41% of patients. In 10 failed cases, excision of the distal end of the clavicle with reconstruction of the coracoclavicular ligament (Weaver and Dunn procedure) resulted in 90% excellent or good results after a 3-year follow-up. A high percentage of excellent results can be expected after this procedure, as long as it is correctly performed.