Patient positioning is a critical component of a shoulder arthroscopy procedure. Careful attention to detail could prevent significant complications. The lateral decubitus position and the beach chair position are the two positions used for shoulder arthroscopies which are briefly discussed in this chapter. Both are reliable methods. Most surgeons use the same patient position to perform all of their arthroscopic shoulder procedures, regardless of the pathology. Each position has its advantages and disadvantages which are also mentioned in this chapter. A proper understanding of shoulder anatomy is essential to appreciate correct portal placements. Posterior portal, anteroinferior portal, anterosuperior portal, lateral portal, neviaser portal, Wilmington portal, etc. are some basic portals.