Objectives: Acromioclavicular (AC) joint disruptions are common shoulder injuries, often requiring surgical intervention for high-grade (Rockwood types IV and V) instability. Traditional fixation methods, such as K-wire stabilization, are associated with high complication rates, including hardware migration and post-traumatic arthritis. This study aims to detail an anatomic surgical technique utilizing suture anchor fixation and evaluate its clinical and functional outcomes. Materials and Methods: A retrospective analysis was conducted on 10 consecutive patients (mean age 32 years) with acute Rockwood Type IV or V AC joint dislocations treated at a tertiary care center in Bangalore. All patients underwent reconstruction using suture anchor fixation supplemented by coracoacromial (CA) ligament transfer. Functional outcomes were assessed using the Constant-Murley Shoulder Score (CMS), and maintenance of reduction was monitored through standardized radiographic protocols. Results: The mean follow-up duration was 12 months (range: 9–23 months). Immediate postoperative radiographs confirmed anatomical reduction in 100% of cases. At final follow-up, the mean Constant-Murley score was 93.2, with 80% of patients achieving full, unrestricted range of motion. Complications were limited to two superficial wound infections; notably, no instances of hardware migration, neurovascular injury, or secondary AC joint arthrosis were observed. Conclusion: Suture anchor fixation, combined with CA ligament transfer, provides a stable, non-rigid construct that effectively restores the anatomy of the AC joint. This technique avoids the catastrophic risks associated with metallic hardware migration and offers excellent functional recovery, making it a viable alternative to traditional transarticular fixation.