Posterior shoulder instability is becoming more commonly recognized and is a problem with the posterior labrum (usually a tear) that can cause pain, dysfunction, and limitation of shoulder activity. Nonoperative management is the mainstay of treatment, including scapular stabilizing exercises, however, in cases that are resistant to a good therapy program, and if pain with activity is present and felt to be due to a posterior labrum tear or injury, the recommended treatment is surgical repair with an arthroscopic labrum repair. may ultimately fail and lead to recurrence particularly in young, male patients. Both arthroscopic and open repair techniques to address posterior instability have been described and shown to be effective. In particular, arthroscopic treatment includes the following: capsular plication and knotted and/or knotless suture anchor fixation. This is my preferred technique to treat recurrent posterior shoulder instability through arthroscopic labral repair using knotless suture anchor fixation.