Background: The objective of this systematic review was to evaluate the reliability and reproducibility of measurements of shortening in midshaft clavicle fractures (MSCF) using any available imaging technique. Methods: Electronic databases (PubMed, EMBASE, and Cochrane) were searched. The 4-point-scale COSMIN checklist was used to evaluate the methodological quality of studies. Results: Four studies on reliability of measurement of MSCF were identified. These studies were of fair and poor quality. The reported intrarater reliability varied between none to fair, and intrarater reliability was minimal. Conclusion: No definite conclusions could be drawn. In order to optimize future studies and the realization of comparable results, more research is necessary to identify a standardized method of imaging and measuring. Level of Evidence III.