Isolated distal clavicle excision performed as an open procedure has been considered safe and, in the literature, has been considered the standard for comparison with arthroscopic distal clavicle excisions. However, we noticed isolated open distal clavicle excision was associated with a number of complications. We therefore raised two questions about the complication rate in a cohort of our patients who had undergone this procedure: (1) What was the complication rate and how did it compare to that in the existing literature on this subject? and (2) Were the complications in our cohort similar to those previously reported? We studied 42 patients who underwent an isolated distal clavicle excision between 1992 and 2003. There were 27 complications (64%), which was substantially higher than rates previously reported. Complications in our cohort not previously reported included continued acromioclavicular joint tenderness and scar hypertrophy. Our study suggests complications after open distal clavicle excisions may be more frequent than and may differ from previously reported rates and types.