Reconstruction in patients with instability with moderate bone loss has been shown to have a much higher failure rate than standard Bankart repair. It has been postulated that the addition of an arthroscopic infraspinatus tenodesis with posterior capsulodesis (“remplissage”) may improve the success rate of arthroscopic reconstruction in these higher risk patients. We report our results with this technique in this patient population. A retrospective review was performed to identify patients who underwent arthroscopic remplissage in conjunction with anterior capsulolabral reconstruction for anterior glenohumeral instability with moderate glenoid bone loss (greater than 10% but less than 40%) at our institution. Thirty-six shoulders in 35 patients with minimum 2 years follow-up were identified. The following data was reviewed: American Shoulder and Elbow Surgeons (ASES) score, physical exam, incidence of recurrent instability, patient satisfaction level and return to sport. Follow up was available for 31 patients (32 shoulders). Mean age at the time of surgery was 23.8 years (range 15-44), with a mean follow-up of 35 months (range 24-60). The mean pre-operative ASES score was 61. Eleven patients (34%) had failed prior instability surgery and underwent capsulolabral reconstruction and remplissage in the context of revision surgery. Twenty-eight of the 31 patients (29 shoulders) were satisfied with their results. The mean post-operative ASES score was 95. Two failures (6.3%) occurred (zero dislocations, two patients with subluxation). There were no limitations in range of motion as compared to the opposite shoulder. Selective biodex testing of the infraspinatus showed no significant deficit in external rotation strength. Although no failures occurred in the eleven patients who underwent reconstruction with remplissage in a revision setting, two of these patients had persistent pain in the operative shoulder without instability symptoms. Aggressive capsulolabral reconstruction with posterior infraspinatus tenodesis in traumatic instability patients with moderate glenoid bone loss and a large Hill-Sachs lesion yields acceptable outcomes. There was no difference in outcome between primary and revision surgery in this case series.