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Aims: To comparison of Scapular Manipulation with External Rotation Method of Reduction of Acute Anterior Shoulder Dislocation for Sedation Requirements and Success Rates.Material and Methods: Thestudywasconducted in the Department of orthopaedic, Madhubani Medical College and Hospital, Madhubani,Bihar, India fromjuly 2019 to January 2020. All 100 patients with clinical and radiographic features of anterior shoulder dislocation (on standard anteroposterior and lateral views) were include and allocated either into the SMM group (50Patients) or the ERM group (50Patients)alternatively on the basis of presentation. The groups were compared for sedation requirements, pain scores, and success rates. Results: There were 50 patients each in the SMM group and ERM group. Both groups were similar in terms of age and sex distribution. Most of the participants were 20–30 years. Out of 100 patients 75% were male and 25% were female. Reductions using SMM had fewer requirements for sedation (16% versus 34%; p<.05) and higher first-pass success rates (84% versus 66%; p<.05) as compared with ERM for anterior shoulder dislocation reduction. The numeric rating score of pain during reduction procedures was less in SMM (mean, 1.77 [standard deviation, 1.7]) than in ERM group (mean, 4.65 [standard deviation, 1.9]; p < .01). The SMM requires less sedation and resulted in lower pain scores as compared with the external rotation technique for reduction of anterior shoulder dislocation. There was no difference in overall success rates of reduction between the two groups. However, the SMM group was more likely to achieve a successful reduction in the first attempt than the ERM group. Conclusion: The greater success for reduction of anterior shoulder dislocation with the SMM when compared with the ERM as the initial attempt technique in nonsedated ED patients with anterior shoulder dislocation. Keywords: shoulder reduction, scapular manipulation, external rotation

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