71 yrs old lady came with history of fall from stairs with sustained injury in her right shoulder. Her xray and CT Scan showed comminuted fracture dislocation right proximal humerus. These cases required meticulous surgical planning in terms of fixation and shoulder Arthroplasty. Intraoperatively we found highly comminuted fracture with dislocated humeral head. Due to poor vascularity and comminution, patient underwent Reverse Shoulder Replacement Surgery. In these age group with limited cuff integrity, reverse shoulder replacement surgery works very well. We routinely performed such complex procedures with great outcomes. Postoperatively patient allowed gentle shoulder movements and elbow ROM exercises.