This chapter presents a detailed description on shoulder replacement in proximal humerus fracture. Proximal humerus fractures account for approximately 4–5% of all fractures. The complex geometry of proximal humerus and intricate arrangements of the muscle forces creates a difficult anatomy to reproduce. Recently reverse total shoulder arthroplasty has been an option as a treatment option when healing of the greater tuberosity is unlikely, and for patients with preexisting rotator cuff insufficiency. A goal of treatment of proximal humerus fractures is to restore function, which depends on various factors such as quality of cuff, age, osteoporosis, size and number of tuberosity fragment, size of humeral head, strong anatomical repair. Indications of hemiarthroplasty are categorized into absolute and relative. A brief discussion on the surgical procedure of this phenomenon has been provided in this chapter which consists of 12 steps i.e. exposure, deep exposure, removal of articular segment, inspection of glenoid articular surface, intramedullary broaching and trial placement, trial reduction, suture placement, cement fixation, tuberosity fixation, suture passing, suture tying, and closure. A detailed description on reverse shoulder arthroplasty (RSR) in proximal humerus fractures has been also covered in this chapter.