Shoulder arthroplasty covers an extensive indication spectrum of degenerative, inflammatory to infectious, tumorous, instability-associated and neurogenic disease to acute trauma and posttraumatic joint destruction. Each of these indications requires its own regime and an appropriate implant. Osteoarthritis is the most frequent indication, and will be used as an example for surgical management, bringing the manufacturer-nonspecific general guidelines, joint mechanics and surgical technology into agreement. The fundamentals of the technique of implantation refer to the anatomical adaptability of the third generation of shoulder prostheses, which permits an accurate reconstruction of glenohumeralen joint centring. This article also describes far-reaching principles, which are generally applicable to all indications for shoulder arthroplasty.