The shoulder is the most frequently affected joint in birth palsy. Normal anatomy and development of the shoulder provides the base upon which discussing pathoanatomy takes place. Classification of shoulder problems in birth palsy is essential for selection of the most proper surgical technique in accordance with the particular pathology of each patient. The most challenging aspect in the assessment of a patient with shoulder problems in birth palsy is to determine reliable, accurate, and practical methods and systems of clinical examination and assessment of motor function. Different imaging techniques and measurements were described for evaluation and classification of shoulder problems in birth palsy including plain X-Ray, CT scan, MRI, arthrography, and ultrasonography. Different treatment options are described according to deformity classification including: internal contracture release techniques, tendon transfers to restore external rotation, external rotation humeral osteotomy, tendon transfers for weak abduction, external rotation contracture release, treatment options for flaccid paralysis of shoulder, correction of scapular winging, and treatment of co-contractions.