Osteochondral transplantation from the knee to the shoulder results in a good clinical outcome in terms of pain relief and functional recovery. The ideal osteochondral defect for an osteochondral autologous transplantation in the shoulder is relatively small; however, the results of study suggest that the development of osteoarthritis and the progression of preexisting osteoarthritic changes cannot be altered by the technique. Osteochondral allograft transfer follows a similar protocol of osteochondral autograft transfer, matching a donor plug to a recipient site, but without the limitations on transferable tissue imposed by donor-site morbidity. The treatment of focal chondral and osteochondral defects of the humeral head remains challenging, especially in younger patients.