Degenerative glenohumeral arthritis in the athlete can be a devastating condition that often impedes performance and may derail a career. Treatment options for this difficult patient population are limited. Conservative therapies and patient education are the mainstays of treatment. However, failing this, there are surgical options ranging from arthroscopic debridement to total joint arthroplasty. In this article, we describe the historical background and a current technique for humeral hemiarthroplasty with biologic resurfacing of the glenoid, including short- and mid-term results. In our experience, this procedure reliably improves pain and function without the concerns of polyethylene wear and glenoid failure associated with traditional arthroplasty in the young, active population.