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Although operative management of shoulder instability has been reported to result in good to excellent functional outcomes, there is still controversy regarding the timing of surgery, how to treat first\u2010time dislocations, and which surgical procedures to use. Patient\u2010specific factors including age, sex, activity level, types of sport, and other comorbidities will influence treatment. In addition, the unique pathology in the shoulder, including presence and degree of bone loss, and concomitant soft tissue pathology will influence the choice of procedures for anterior stabilization. Surgeon\u2010specific factors such as surgeon's preference, which procedure the surgeon is comfortable with, and training and experience are also important. Finally, the financial burden of the procedure cannot be overlooked. With so many factors playing a role in a surgeon's treatment algorithm, a thorough preoperative assessment is important in guiding decision making. 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