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Glenohumeral arthritis has traditionally been a disease with a limited arsenal of treatment. Once medical management is no longer effective for pain relief, patients usually are offered a shoulder arthroplasty as the main surgical treatment. This operation is reliable for pain relief, but not as efficient in reestablishing motion to the patient. Moreover, patients with glenohumeral arthritis are often older, and have associated co-morbidities with multiple medical conditions that may be contraindications to a major surgery. A less invasive arthroscopic debridement of patients with severe grade IV glenohumeral arthritis has shown reliable improvements in both pain and function. Isolated arthroscopic debridement is a relatively low risk procedure that relieves pain in nearly 80% of patients with severe glenohumeral arthritis by 3 months, and may provide relief for more than 4 years. It can be considered as a temporizing procedure that may be included in the algorithm of management of patients with severe shoulder arthritis.