Fractures of the humeral shaft can be successfully treated either nonoperatively with functional bracing or surgically. Common indications for surgery include failure of conservative management, patient request, polytrauma, open fractures, vascular compromise, and segmental injuries. The surgical approach, desired stability, and implant choice are driven by fracture location and characteristics, as well as host considerations. Operative stabilization of humeral shaft fractures is generally safe and reliable, but complications including nonunion, infection, and radial nerve palsy can occur.