Objectives: This work was to compare functional shoulder recovery in proximal humeral fractures (PHFs) after fixation by PHILOS plate with versus without bone graft. Background: PHFs are the 3rd highly occurred in elderly cases, and their management remains a challenge. The benefit of locking compression plate (LCP) offers positive outcomes for misplaced PHF. Patients and Methods: This every other case prospective research involved 34 patients with proximal humeral fractures. They were equally allocated into two groups. Group I: seventeen patients are only treated with a PHILOS plate, and Group II: seventeen patients are treated with a PHILOS plate and bone graft. Adult patients with comminuted, closed, 3 or 4 parts fractures were included, while patients with open, pathological, associated other upper limb fractures and rheumatoid patients were excluded.