Osteoarthritis is a slowly progressive disease that appears to primarily affect articular cartilage. The main symptom in the glenohumeral joint is diffuse, achy, and insidiously progressive pain. The first shoulder arthroplasty was performed over 100 years ago, however, over the past several decades significant advances have been made in the field of total shoulder arthroplasty. Total shoulder arthroplasty has become the standard treatment for advanced osteoarthritis of the glenohumeral joint that does not respond to nonoperative measures. With the proper surgical technique, consistently good to excellent results can be obtained.