Aim: 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: The study was conducted in the Department of Orthopaedics, Vardhman Institute of Medical Sciences, Pawapuri, Nalanda, India.from December 2016 to January 2017. All 120 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 (60Patients) or the ERM group (60Patients) alternatively on the basis of presentation. The groups were compared for sedation requirements, pain scores, and success rates. Results: Of the 120, 60 patients each in the SMM group and ERM group. Out of 120 patients 74.17% were male and 25.83% were female. Reductions using SMM had fewer requirements for sedation (20% versus 35%; p<.05) and higher first-pass success rates (80% versus 65%; 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, 1.82 [standard deviation, 1.9]) than in ERM group (mean, 4.87 [standard deviation, 1.8]; p<0.01). Conclusion: The technique of choice to treat shoulder dislocations ultimately is chosen by the doctor/clinic itself. However, further analysis of various methods could help to improve the efficacy of treatment.