Since 1954 when the French surgeon Michel Latarjet described the open transfer of the coracoid process and conjoint tendon to the anterior rim of the glenoid to restore anterior shoulder stability, this surgery has become an established solution for managing anterior instability with glenoid bone loss or following failures of other soft tissue surgical techniques. While the evidence solidly demonstrates its efficacy in preventing re-dislocations, improving shoulder function, and increasing patient satisfaction, complications range from neurological injuries (fortunately, mostly transient), recurrences, and glenohumeral arthritis. In this chapter, we delve into the various aspects of open Latarjet surgery, including the impact of some modifications to the original technique.