Forty-one patients with a clinical presentation of posterior shoulder instability were treated with one of four surgical techniques designed to correct the capsuloligamentous disorder responsible for the instability. The patterns of capsuloligamentous disease are identified. The four surgical techniques are described and their indications are discussed. At follow-up (mean, 10 months), the results were assessed with the Neer-Foster Rating Scale. In 39 of the 41 patients (95%) outcome was satisfactory.