The shear and tensile stabilities of highly inclined non-circular wellbores are investigated in this study. Using the equivalent-ellipse hypothesis, the non-circular geometry was approximated as an ellipse, and the corresponding stress concentration equations are presented. With the new set of stress concentration equations, a comprehensive study of the tensile and shear stabilities of an elliptical borehole was conducted, including the impact of well inclination and azimuthal angles, horizontal stress difference, degree of ellipticity, and orientation of the maximum horizontal stress to the major axis of the ellipse. Using five commonly used shear failure criteria, we observed that both Mohr-Coulomb and Drucker Prager (inscribed) failure criteria predicted higher collapse pressures, relative to the others including Drucker Prager (inscribed), Mogi-Coulomb, and Modified Lade. While Drucker Prager's (circumscribed) failure criterion underestimates the collapse pressure. Both the linear elastic and poroelastic models were used in investigating the fracture initiation orientation and pressure of highly inclined elliptical boreholes. The prediction from the poroelastic model is always less than the linear elastic model. In some instances, they predict different fracture initiation orientations. From this study, we observed that generally, a near-circular wellbore is more stable than elliptical borehole in both shear and tension. Nevertheless, there are some well inclination and azimuthal angles than can make an elliptical borehole have more shear and tensile stabilities than a near-circular wellbore.