INTRODUCTION: Anterior dislocation of the shoulder joint with an ipsilateral fracture of the humeral shaft is a rare injury which may require demanding technical skills. CASE PRESENTATION: A 33 years old male sustained a work accident. Radiographs showed an anterior dislocation of the shoulder with a transverse fracture of the middle third of the humeral shaft on the same side. The dislocation proved to be irreducible in the setting of the fracture humerus. Thus, stabilization of the shaft fracture was successfully applied with an intramedullary nail and a small antirotational plate prior to the reduction. The patient recovered full function of the shoulder. CONCLUSION: Performing primary intramedullary nailing of the humeral shaft fracture before manipulation of the joint resulted to an excellent outcome.