The shoulder girdle is comprised of the clavicle, scapula, and soft tissue support structures. Traumatic injuries to the shoulder girdle are common, and include injuries to the clavicle and scapula, as well as injuries to the sternoclavicular, acromioclavicular, and glenohumeral joints. These injuries can be easily missed or underdiagnosed due to the complex anatomy of the shoulder. Radiographs should be performed for initial evaluation, preferably in upright positioning to accentuate bone displacement in unstable injuries. A low threshold should be maintained for performing CT of the shoulder to further evaluate for fracture, particularly when injuries to the sternoclavicular joint or scapula are suspected. CT angiography can help assess for arterial injury, but is rarely necessary as vascular injury is very uncommon in the setting of shoulder trauma. MRI is helpful for evaluating ligament integrity in joint dislocations as well as for assessing injuries to muscles, tendons, and nerves. However, MRI is rarely performed in the emergency setting. Ultrasound is also helpful for assessing soft tissue injury, but has limited use in the acute setting due to challenges in positioning the acute injured patient as well as the high level of expertise required to accurately perform musculoskeletal ultrasound.