This symposium celebrates the advances in shoulder arthroscopy that now make arthroscopic treatment of most problems affecting the shoulder routine. Just 10 years ago, such a statement would not have been accurate. The evolution of arthroscopy is largely attributable to an improved understanding of the pathology and biomechanics of the shoulder, which has come about as a result of an exponential growth in basic science work. A parallel growth of new instruments and implants has complemented this enlightened understanding of shoulder disease. The individuals who have been asked to contribute to this symposium represent some of the brightest and most creative clinicians. Indeed, the authors whom we have asked to contribute are an interesting combination of creative designers of new instruments, implants and techniques, and expert arthroscopists. We acknowledge, however, that all of the work is based on the ideas and techniques of many innovative surgeons and scientists. Patient acceptance for less morbid alternatives to open surgery and the socioeconomic demands for less costly alternatives of treatment also have motivated this growth and enthusiasm for operative shoulder arthroscopy. Although there recently has been some scientific evidence that these techniques really are as good as conventional open approaches, there is an overwhelming perception that in choosing them, we reduce our patients’ discomfort and overall morbidity. Increasing enthusiasm for these arthroscopic techniques, however, should be tempered by realistic appraisals of the skill required to complete these demanding procedures successfully. Symposia such as this and educational initiatives of the American Academy of Orthopaedic Surgeons, the Arthroscopy Association of North America, the American Orthopaedic Society for Sports Medicine, and the American Shoulder and Elbow Surgeons, will be largely responsible for the continuing education of orthopaedic surgeons interested in learning the skills required to perform these procedures. It is an honor for us to coordinate a symposium, which updates the state of the art at the beginning of the new millennium. The diversity of input and varied techniques in this symposium provide a rich source of educational content from which we all stand to learn something new and relevant.