Posterior shoulder fracture-dislocation is a rare injury accounting for approximately 0.9% of shoulder fracture-dislocations and often misdiagnosed during the initial presentation to a physician. Though the reverse Hill-Sachs lesion is a common injury associated with posterior shoulder dislocation, the associated scapula fracture represents only 6% of the lesions associated with a posterior dislocation of the shoulder. We report the case of a neglected posterior shoulder dislocation with a reverse Hill-Sachs lesion treated by filling with an autologous graft associated with an extra articular fracture of the scapula fixed by a plate and a posterior bone end-stop because of the posterior instability. After two years of follow-up, the patient has no episode of dislocation and is satisfied with the functional result with a constant score of 68/100 points.