The throwing athlete is a unique patient. High demands on the shoulder, combined with poor tolerance for slight changes in performance, make this a particularly difficult group of patients to treat successfully. In addition, there is overlap between multiple pathologic conditions in the shoulder, including rotator cuff tendinopathy, shoulder instability, SLAP lesions, acromioclavicular arthrosis, and scapulothoracic problems. These disorders rarely occur in isolation in the throwing athlete. Arthroscopy of the shoulder may be invaluable as a diagnostic tool to confirm clinical and radiographic abnormalities, to identify associated intra-articular and extra-articular pathologic conditions, and to treat a variety of these lesions without the attendant morbidity of open surgical repair and reconstruction.