Ipsilateral fracture of the clavicle and scapula is considered to be a relatively rare injury. It is perceived as an unstable injury and is at times called floating shoulder. Understanding of the role played by the bony and ligament stability is important to identify true floating shoulder injury and to offer an appropriate treatment. Both conservative and surgical treatment modalities are described in the literature. Recent literature has shown the important role played by the ligaments in providing stability in ipsilateral fracture of the clavicle and scapula. In a true floating shoulder injury, it seems important to stabilise the injury by fixation of the scapular fracture. This article reviews the literature to identify the injury pattern of true floating shoulder and to look at the current evidence for the treatment of such an injury.