We present a case of synovial chondromatosis of the shoulder in a 22-year-old man. The patient was initially treated with arthroscopic debridement and partial synovectomy of the shoulder joint. Eighteen months later, the patient returned with similar symptoms. However, repeat radiographic studies showed involvement of both the shoulder and biceps tendon sheath. The patient was taken back to the operating room for an arthroscopic debridement of the shoulder joint and debridement of the biceps tendon sheath through an open approach. Use of the arthroscope to evaluate and treat this patient allowed him to return to normal activities much sooner than a formal open synovectomy would have allowed. Additionally, the morbidity associated with arthroscopic techniques is much lower than that of open procedures. In cases of synovial chondromatosis, the results in terms of efficacy and recurrence rates of each method appear comparable.