Shoulder arthroplasty is now one of the fastest growing orthopaedic reconstructive procedures, offering excellent results for both humeral head and total joint replacement. This essay discusses the development of shoulder replacement surgery; the peculiar anatomy and biomechanics of the glenohumeral joint, the different indications and contraindications for shoulder arthroplasty, preoperative clinical and radiographic evaluation, a thorough history of the development of shoulder arthroplasties over the last 100 years and an in-depth review of the available prostheses. Finally, the current concepts and controversial issues in shoulder arthroplasty are presented.