Anterior shoulder dislocation often results in Hill Sachs lesion that can vary in size and clinical significance. Osseous defects have a direct impact on recurrent instability by altering joint contact area, congruency, and function of the static restraints. Smaller but clinically significant bony defects of the humerus following a shoulder dislocation can be treated with remplissage technique and/or Latarjet procedure to convert and “off track lesion” to an “on track lesion” to prevent recurrent shoulder instability. Larger defects on the humeral head have an impact in the recurrence rate of the dislocated shoulder and must be addressed. Large Hills Sachs lesions require more advanced techniques including humeral head augmentation with allograft tissue, humeral osteotomy, as well as resurfacing or arthroplasty procedures. This chapter focuses on humerus bone augmentation techniques to manage severe humeral head bone loss following shoulder dislocation.