Recently, there has been an upsurge of interest among the orthopaedic sports medicine community in Asia on this subject of athletic shoulder instability. This is particularly prominent in countries such as Japan, Korea, Taiwan, and Hong Kong, where sports requiring throwing and overhead use of the upper limb are popular. In this review, the classification of the condition is analyzed with a specific account of the rotator interval injury. A systematic plan of clinical assessment is presented highlighting the specific regional considerations in clinical practice and cost-effectiveness of the health care systems in Asia. The management of athletic shoulder instability depends on patient attitude and cultural background. In Asia, the popular choice of Bankart repair with capsular shift procedure is presented with special reference to the unique experience of multidirectional and habitual posterior instability. Arthroscopic surgery is becoming popular in Asia, and the indications and limitations of the technique in the management of shoulder instability are discussed.