Congenital pseudarthrosis of the clavicle is an entity that has rarely been recorded in the literature. The clinical characteristics and long term follow-up of five cases are reported. Differentiation from cleidocranial dysostosis and post-traumatic pseudarthrosis is made. The embryologic development of the clavicle is described, and speculations are made as to the development of this lesions. Conservative management of this condition is recommended.