Operative fixation of the scapula is associated with good outcomes. Techniques have been developed to facilitate surgical exposure of the osseous anatomy so that stability can be achieved. Although the familiar deltopectoral approach can be used for anterior glenoid fractures, the more common exposure is a posterior approach for fractures involving the neck and body of the scapula. The posterior approach has been nuanced to match needs related to fracture pattern and timing of surgery. Reducing the fragments and stabilizing them can be challenging but, a satisfactory reduction and stable fixation can be achieved, which allows immediate motion and rehabilitation.