Glenoid bone loss remains an important determinant of outcome in the surgical management of anterior shoulder instability. Multiple options are available to address this bone loss including autograft bone transfers, such as coracoid or iliac crest grafts. Allograft options include both bone and osteochondral options, such as the distal tibial allograft. Each of these choices has potential advantages and disadvantages. An ideal approach would provide an autograft source of osteochondral material that is well-matched to the defect, readily available, cost effective, and with minimal morbidity. In this article, we present the distal clavicle autograft as an ideal option for consideration in the treatment of glenoid bone loss. The graft has a cortical and cancellous side for direct fixation and is amenable to arthroscopic techniques using standard portals and obviating the need to go near the neurovascular structures of the shoulder. Recent work has demonstrated the utility of this graft in providing an anatomic restoration of the glenoid articular surface with a cartilage cap comparable in thickness to that of the native glenoid. Along with a summary of the pertinent literature, this article outlines the rationale, indications, and technical evolution for this procedure.