Posterior Bankart lesions or rupture of the posterior-inferior capsulolabral complex can lead to significant symptoms of posterior shoulder instability and pain. The incidence of this pathology is quite rare when compared with its anterior counterpart. Recently, increased awareness and the ability to diagnosis this lesion has lead to a more aggressive approach to treatment. Although open procedures have been used in the past with mixed results, currently, arthroscopic repair with capsular plication provides a promising future. Our technique for arthroscopic posterior Bankart repair with capsular plication will be reviewed with emphasis on the key aspects for a successful outcome.