Abstract The fracture morphology interpreted from initial radiographs is a snapshot of the bony fragments affected by the action of superficial and deep muscles. It reflects the condition of the rotator cuff and the existing bone stock. The natural course of displacement in a humeral neck fracture in older people includes translation or impaction followed by healing and consolidation of the fracture complex. Lateral and posterior bone bridging and the formation of endosteal callus are prerequisites for pain relief, improved shoulder function, and increased quality of life. In osteoporotic bone, some degree of humeral head collapse can be expected. The radiographic appearance changes over time and should not be considered an independent indication for surgery except in rare cases of fracture-dislocations or head-splitting fractures. The use of rigid implants may improve the initial radiographic appearance, but the rates of complications associated with osteosynthesis are high. It is yet to be demonstrated whether osteosynthesis is superior to natural healing. This chapter provides an illustrated guide to the most common morphological patterns. The account is descriptive and strives to remain neutral toward classification systems.