Congenital pseudarthrosis of the clavicle is a rare condition, and optimal treatment strategies are controversial because this benign condition rarely produces functional disabilities except for an unsightly lump and occasional mild weakness of muscle strength around the shoulder girdle. Nevertheless, its prominence increases with age and it can cause cosmetic problems by drooping and shortening of the shoulder. Thoracic outlet syndromes have been reported in a few patients who did not receive treatment. The authors here report on congenital pseudarthrosis of a unilateral clavicle in 3 patients and bilateral clavicles in 1 patient. All patients were treated with autogenous iliac bone grafts and internal fixation, with a complete union and cosmetically satisfying results.