Purpose <p>Proximal humerus fractures can be treated non-operatively with excellent results in the vast majority of cases. Surgical intervention is indicated for more complex fracture patterns, utilizing internal fixation or arthroplasty techniques. The aim of this study was to evaluate the long-term functional outcomes of patients who underwent shoulder hemiarthroplasty due to proximal humerus fracture.</p> Methods <p>A retrospective chart review of patients who underwent shoulder hemiarthroplasty due to proximal humerus fracture in the University Hospital of Heraklion, utilizing the Aequalis fracture prosthesis, during the period between 2004 and 2016 was conducted. Functional outcome was assessed using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and the Shoulder Pain and Disability Index (SPADI).</p> Results <p>Twenty-nine patients were included in the study, 14 male and 15 female, with a mean age of 65.9 years (range 38–89). Revision surgery was not required in any of the patients. The mean value for the SPADI score was 36.81 ± 28.6 SD and 26.7 ± 22.5 SD for the DASH score. Both questionnaire score values were higher in female patients and patients with involvement of the dominant arm.</p> Conclusion <p>Treatment of proximal humerus fractures with shoulder hemiarthroplasty utilizing specifically designed fracture implants and meticulous surgical technique can offer satisfying long-term functional outcomes, with a significantly lower cost for healthcare systems. Prospective studies with long-term follow-up for proximal humerus fracture patients treated with hemiarthroplasty are required to further validate these results.</p>