Background <p>Glenohumeral osteoarthritis (GHOA) affects not only older individuals but also an increasing number of younger active patients, for whom joint replacement is often not the first-line treatment option. For this demanding patient population, joint-preserving procedures are becoming clinically more important. Comprehensive arthroscopic management (CAM) and other structured arthroscopic techniques represent a&#xa0;stepwise holistic approach aimed at addressing multiple pain generators and delaying the need for arthroplasty. Nevertheless, the indications, surgical techniques and long-term outcomes remain the subject of ongoing discussion.</p> Purpose <p>What indication criteria and inclusion or exclusion factors should be considered for CAM and other arthroscopic procedures in glenohumeral osteoarthritis? Which operative steps are characteristic and what clinical outcomes have been reported in the current literature?</p> Methods <p>Narrative review of published studies with a&#xa0;particular focus on the CAM.</p> Technique/results <p>The CAM procedure includes capsular release, débridement of unstable tissue, chondroplasty, synovectomy with adhesiolysis, inferior humeral osteoplasty and microfracture. Depending on preoperative and/or intraoperative findings, additional procedures such as neurolysis of the axillary nerve, subacromial or subcoracoid decompression and biceps tenodesis can also be performed. In carefully selected patients, these arthroscopic procedures can provide not only significant pain reduction and functional improvement but also delay the need for shoulder arthroplasty.</p> Conclusion <p>Structured arthroscopic techniques and the CAM procedure can represent valuable treatment options for carefully selected patients, particularly those under 50&#xa0;years of age with moderate osteoarthritis. Strict patient selection, thorough preoperative counselling and handling of realistic expectations are essential for achieving successful outcomes.</p>