Abstract Fractures of the humeral shaft are relatively common and can occur in any a variety of age groups, and due to a variety of mechanisms of injury. The anatomy of the humeral shaft is vital to understand, to be able to plan management of these fractures: the intricate relationship of the radial nerve with the humeral shaft in particular, plays an important role in these fractures. Though non-operative measures are commonly employed for humeral shaft fractures routinely, there are some indications for operative management. There remain a variety of operative interventions available to a surgeon, all with pros and cons associated. This review aims to look in detail at the anatomy of the humeral shaft, the types and sites of fractures, the evidence and surgical methodology of the most common surgical interventions, including a discussion about the surgical complications, particularly a radial nerve palsy.