The foundations of the art of surgery are based on a sound knowledge of anatomy and its variations under physiological and pathological conditions. Functional anatomical aspects of the glenohumeral joint are emphasized as they relate to the more commonly described surgical exposures of that joint. Adequately coordinated cuff muscles provide the major stabilizing component of the joint. Bone prominences form the principal anatomical landmarks. Correctly placed skin incisions ensure a more satisfactory postoperative scar. Problems in the management of the deltoid umbrella are discussed. The anterior, posterior, and superolateral surgical approaches to the shoulder joint are presented with answers to some of the anatomical questions encountered.