Abstract: Proximal humerus fracture accounts for 5% of all fractures, and it becomes the third most common fracture after hip fracture and distal radial fracture. For the proximal comminuted humerus fractures, especially for patients with severe displacement or posterior medial cortical defects, surgical treatment is still the main treatment including percutaneous Kirschner wire fixation, plate-screw internal fixation, intramedullary nail fixation and joint replacement. However, ideal treatments to maximize outcomes remain controversial. The advantages and disadvantages of each treatment mentioned above will be summarized in this article.