Isolated, full-thickness chondral lesions of the glenohumeral joint remain significant problems for athletes, workers, and the elderly. Microfracture has been established as an effective therapeutic solution for such cartilage defects of the knee, because of its low surgical morbidity and ease as a first-line treatment with good clinical outcomes. Although the indications for microfracture and the surgical techniques are similar for cartilage injuries of the shoulder and knee joints, the literature includes no reviews of the use of microfracture in the humeral head or glenoid surface. Overall, microfracture is a minimally invasive, technically simple surgical procedure that provides an excellent option for patients with isolated full-thickness chondral defects. In this article, we describe the subtleties of microfracture in the glenohumeral joint and outline the clinical course of a typical patient.