Shoulder arthroscopy has become a widely practiced procedure with predictable results. Shoulder arthroscopy and open shoulder surgery by themselves have become a subspecialty of orthopedics. But shoulder arthroscopy is a complex procedure which demands specialized training and psychomotor skills. In this chapter, the fundamentals of performing shoulder arthroscopy will be discussed. The common indications for shoulder arthroscopy include shoulder instability, rotator cuff tears, impingement, superior labrum, anterior to posterior (SLAP) lesions and adhesive capsulitis. Prerequisites for shoulder arthroscopy, anesthesia for shoulder arthroscopy, operating room set-up, patient positioning including beach-chair position and lateral decubitus position, examination under anesthesia, arthroscopic portals, joint distention and fluid management, diagnostic arthroscopy, and complications of shoulder arthroscopy are the topics which are covered in this chapter.