The acromioclavicular joint (ACJ) represents the main connector between the axial and appendicular skeleton. Chronic ACJ instability disrupts the shoulder girdle’s synchronized dynamic, leading to a significant limitation in daily activities and chronic pain secondary to osteoarthritis. In most cases, surgical intervention is recommended to restore its integrity. Thus, various procedures, including anatomical and non-anatomical reconstruction, have been proposed in the literature; however, none have shown superior to one another. Furthermore, a combination technique has not been discussed. The authors present a case of chronic ACJ injury (Rockwood type V), which was successfully treated with a combination of anatomical reconstruction of the coracoclavicular (CC) ligament using semitendinosus tendon allograft with bio screw fixation and non-anatomical stabilization of ACJ with button suture technique.