Background: The optimal surgical approach to base of coracoid fractures (Eyres III-V, Ogawa I) remains a contentious topic for an exceedingly uncommon fracture pattern.(1) This is partly due to the anatomical restrictions interfering with the optimal insertion angles for screw fixation.(2) This article describes the first reported use of a novel transclavicular approach to the base of coracoid. Clinical Case: A male rugby player in his early twenties sustained a shoulder injury from a blow to the left shoulder. Subsequent X-ray and CT found an acute comminuted base of coracoid fracture with anteromedial displacement of the coracoid process, as well as a comminuted scapular body fracture with extension into the glenoid neck. 16 days post-injury, the patient underwent open reduction and internal fixation (ORIF) of the base of coracoid via an extended deltopectoral approach and crescenteric clavicular osteotomy. Sufficient space was created through release of soft tissues and dissection of the rotator interval. Anatomical reduction was confirmed with intraoperative imaging and the coracoid was fixated with partially threaded cannulated screws. Post-operatively, the patient was compliant with 6- weeks of restricted weight bearing in an abduction sling followed by rehabilitation. Conclusion: The transclavicular approach is a novel surgical technique allowing for optimal ORIF of the base of coracoid under direct visualisation. This article illustrates a promising solution to this area of contention and warrants further comparative studies. References: 1.Pires RE, Giordano V, de Souza FSM, Labronici PJ. Current challenges and controversies in the management of scapular fractures: a review. Patient Saf Surg. 2021 Jan 6;15(1). 2. Trikt van, Dobbe G, J. C. E. Donders, Streekstra GJ, P. Kloen. The “coracoid tunnel view”: a simulation study for finding the optimal screw trajectory in coracoid base fracture fixation. Surg Radiol Anat. 2019 Jul 4;41(11):1337–43.