Most proximal humerus fractures can be treated non-surgically with an acceptable result. Approximately one in five patients are assessed for surgery. Clinical examination and diagnostic imaging with radiographs in two planes are needed for the initial assessment, while shoulder CT provides important additional information. To achieve optimal shoulder function after the fracture, patients must be motivated to perform self-exercises and receive supervised training from a physiotherapist. The patient's cooperation is therefore key to achieving an acceptable result, especially if surgery is being considered. Not all patients regain normal shoulder function after such an injury. This clinical review article summarises some important considerations for doctors working with these patients.