Objective To investigate the reduction technique and clinical effect of counter-traction against irreducible anterior shoulder dislocation combined with Hill-Sachs lesion. Methods The clinical data on twenty-six patients with irreducible sub-coracoid shoulder dislocation combined with Hill-Sack lesion who had received the counter-traction reduction in our hospital between January 2017 and December 2020 was retrospectively reviewed. The visual analogue scale (VAS) score, reduction success rate, duration of reduction, the Faces Rating Scale (FRS) score during reduction, and related complications were recorded. Results In these patients, the mean VAS score was 7.23±2.19 preoperatively, the mean FRS score was (2.04±0.37) intraoperatively, the mean VAS score was 7.23±2.19 postoperatively, and the mean duration of reduction was (6.35±2.31) minutes. The reduction success rate was 96.15%. No vascular or nerve injury or iatrogenic fracture occurred during the reduction. The average constant score at 6 weeks after reduction was 91.71±6.28. No dislocation occurred during the follow-up. Conclusions Under intra-articular anesthesia of the shoulder, the success rate of counter-traction for reduction of sub-coracoid shoulder dislocation with Hill-Sack lesion is high with fewer complications, and most patients are satisfied with the outcome.