Double contrast computerized tomographic (CT) shoulder arthrograms of 55 shoulders were reviewed. This investigation was compared with conventional arthrograms and the findings were correlated with subsequent clinical and surgical follow-up. CT arthrograms were found to be useful in demonstrating bony, ligamentous and cartilaginous structures and have helped the surgeon in deciding the approach and type of surgical procedure. Indications for CT arthrography are recurrent dislocation, multidirectional instability, severe rheumatoid arthritis and other arthritides, complex shoulder deformities and suspected loose bodies. We found that this examination was not as helpful for rotator cuff injuries, impingement syndrome, adhesive capsulitis and in cases of vague or mild shoulder pain.