Shoulder instability is an important issue mainly characterized by anterior instability but also including posterior and multidirectional presentations. It outlines risk factors such as participation in contact sports, younger age, hyperlaxity, and previous dislocations. Bone loss, particularly on the glenoid, is highlighted as a significant challenge, affecting clinical outcomes following stabilization procedures. Recent evidence suggests that even relatively modest levels of glenoid bone loss can lead to unsatisfactory results. Additionally, the presence of humeral Hill-Sachs lesions, often accompanying glenoid bone loss, further complicates the situation. Surgical approaches have evolved over time, from historic open procedures to modern arthroscopic techniques, with various graft options available to address bone loss and other related issues. The text underscores the importance of careful consideration in selecting the appropriate bone graft based on the specific characteristics of the instability and associated bone loss.