Surface replacement arthroplasty is a conservative means of joint replacement in the shoulder that has many applications. This paper will provide a series of technical tips on patient indications and contraindications, surgical techniques, and application in the special conditions in which this bone-sparing prosthesis can become a valuable tool in the hands of the shoulder surgeon faced with a variety of challenging conditions. Specific surgical techniques in the application of cup arthroplasty reconstruction are demonstrated as alternatives to more invasive, less conservative forms of arthroplasty.