Advances in modern arthroscopy have contributed significantly to greater flexibility and efficacy in addressing shoulder pathology. Advantages of arthroscopy include less invasive approaches, improved visualization, decreased risk of many postoperative complications, and faster recovery. As a result, arthroscopy is often preferred by both orthopaedic surgeons and patients. Common shoulder conditions that can be managed arthroscopically include rotator cuff tears, shoulder instability, and labral pathology. A thorough understanding of anatomic principles in conjunction with proper patient positioning and portal selection and placement are essential for successful arthroscopic shoulder surgery.