Nonoperative treatment has long been the norm for clavicle fractures. However, more recent evidence indicates that shortening or poorly healed fractures lead to considerable loss of arm function. A logical treatment algorithm for clavicle fractures based on up-to-date scientific data was developed, and the operative technique of intramedullary nailing of the clavicle is here described and demonstrated with instructive diagrams. Along with surgical indications, the preoperative, perioperative, and postoperative management is detailed. Operative hints and tricks are explained, the known complications and pitfalls of the procedure are analyzed, and avoidance strategies are offered.