Summary Management of the low tone subluxed shoulder has been an issue for therapists working with neurological patients for many years. Various modalities have been suggested for realigning the glenohumeral joint, but their use is controversial. The purpose of this paper is to review critically the evidence base in order to inform the clinical decision-making process for physiotherapists working in neurology. Literature has identified supports, strapping and functional electrical stimulation (FES) in the management of low tone shoulders. Following review of this evidence it is suggested that there is a lack of reliable and valid research evidence on which to base conclusions. The modalities with the best supporting evidence for realigning the low tone subluxed glenohumeral joint are the triangular sling, Harris hemi sling and the Rolyan humeral cuff used in a standing position and the lap board and arm trough while the patient is sitting. However, due to soft tissue adaptation with associated lack of movement, over-correction and the need for careful patient positioning these supports need to be evaluated for each patient and should be used only in appropriate situations. Similarly, there is a lack of evidence on the effects of long-term use of this equipment. Electrical stimulation is also thought to have potential in the treatment of subluxed low tone shoulders but additional research is required to clarify the parameters for use and the long-term effects of these forms of management. Management of the low tone subluxed shoulder has been an issue for therapists working with neurological patients for many years. Various modalities have been suggested for realigning the glenohumeral joint, but their use is controversial. The purpose of this paper is to review critically the evidence base in order to inform the clinical decision-making process for physiotherapists working in neurology. Literature has identified supports, strapping and functional electrical stimulation (FES) in the management of low tone shoulders. Following review of this evidence it is suggested that there is a lack of reliable and valid research evidence on which to base conclusions. The modalities with the best supporting evidence for realigning the low tone subluxed glenohumeral joint are the triangular sling, Harris hemi sling and the Rolyan humeral cuff used in a standing position and the lap board and arm trough while the patient is sitting. However, due to soft tissue adaptation with associated lack of movement, over-correction and the need for careful patient positioning these supports need to be evaluated for each patient and should be used only in appropriate situations. Similarly, there is a lack of evidence on the effects of long-term use of this equipment. Electrical stimulation is also thought to have potential in the treatment of subluxed low tone shoulders but additional research is required to clarify the parameters for use and the long-term effects of these forms of management.