Both operative and nonoperative management of the unstable shoulder requires a thorough understanding of the natural history of instability, as well as the normal anatomy and biomechanics of the shoulder joint. Failure of management may occur at any time during the course of treatment, and may be a result of either physician or patient error, or a combination of both. The correct diagnosis allows for selection of the most appropriate treatment, and the success of surgical treatment depends on proper recognition of the pattern of instability and technically adequate anatomic capsulolabral reconstruction. Complications that can occur include making the shoulder too loose or too tight, injury to the neurovascular elements about the shoulder, and articular injury from hardware usage about the shoulder.