Objective To investigate the application of the O-arm imaging system in open reduction and internal fixation for coracoid fracture.Methods An analysis was performed for the clinical data of a patient with coracoid fracture and acromioclavi-cular dislocation who underwent surgical treatment assisted by the O-arm imaging system,and a literature review was also per-formed.Results Compared with the traditional C-arm X-ray instrument,the O-arm imaging system used during surgery could realize precise screw placement for coracoid fracture internal fixation,shorten the time of operation,and avoid complications.Conclusion The intraoperative application of the O-arm imaging system can improve the accuracy and safety of open reduction and internal fixation for coracoid fracture.