Shoulder arthroscopy can be a safe and effective tool to perform a variety of diagnostic and therapeutic procedures about the shoulder. Careful attention to positioning, fluid management, use of traction, and appreciation of shoulder anatomy to select portal placement will help decrease the common complications associated with shoulder arthroscopy. The awareness of uncommon complications, such as deep venous thrombosis, pneumothorax, and iatrogenic rotator cuff tears will help the orthopedic surgeon to promptly diagnose and treat these problems.