Background : Proximal humeral fractures account for about 10% of all fractures and is the 3rd most common fracture in the elderly population. Shoulder hemiarthroplasty is performed mainly in patients with Neer four-parts fractures and fracture dislocations, anatomical neck fractures, head-splitting fractures that cannot be anatomically reduced and stabilized and head impression fractures involving greater than 40% of the articular surface. Aim : To evaluate the short term results in treatment of complex proximal humerus fractures and fracture dislocations by shoulder hemiarthroplasty .Patients and methods : A prospective study conducted on twenty consecutive patients with complex proximal humerus fractures and fracture dislocations who have been treated by shoulder hemiarthroplasty between January 2020 and October 2021 in Benha University hospitals. Results : The mean age of the studied patients was 61.1 years old. According to Neer classification most of studied patients found to have 4-part fracture (50%). According to modified constant score, five patients (25%) showed excellent results with mean value of 84.4. Eight patients (40%) showed good results with mean value of 65.3. Five patients (25%) showed fair results with mean value of 44.6. Two patients (10%) showed poor results with mean value of 24. The mean duration of postoperative follow up was 14.4 months.Conclusion : Shoulder hemiarthroplasty is a reliable method for treatment of acute complex proximal humerus fractures and fracture dislocations which are not amenable for fixation.