Shoulder dystocia is a serious complication of delivery where one of the baby’s shoulders gets impeded usually behind the mother’s symphysis pubis. It is an obstetric emergency which must be resolved quickly. It is associated with brachial plexus injury but there is a school of thought that such injury is entirely avoidable. In this case note Justin discusses the issues raised in a recent case of probable posterior shoulder dystocia which, in the event, was compromised.