Anterior shoulder instability with bipolar bone loss is poorly served by isolated soft-tissue repair, whereas the Latarjet procedure addresses both osseous deficiency and dynamic stabilization. Building on the Lafosse fully arthroscopic technique, we summarize indications, imaging work-up, key steps, and outcomes from a large single-center experience. Indications included post-traumatic instability with significant glenoid erosion and/or “off-track” Hill–Sachs lesions; a simple, reproducible Gerber index >40% triggered selection of arthroscopic Latarjet. The technique enables precise bone block placement, optimal screw orientation, and simultaneous management of associated lesions, with nerve control and multiportal visual checks to avoid overhang. In our consecutive series (2010–2020; n = 950 instabilities: 473 Bankart + Remplissage, 477 arthroscopic Latarjet), recurrence rose over time after bipolar fixation (≈20% at 8 years) but remained <2% after arthroscopic Latarjet, leading to its use in >90% of cases and the discontinuation of open Latarjet. Early learning-curve data (first 104 cases) showed no vascular injuries, one transient axillary neuropraxia with full recovery, and 5.7% reoperations mainly for hardware issues after fusion. Arthroscopic Latarjet is therefore a reliable, reproducible, and efficient option for most instability patterns, including selected hyperlaxity, provided the learning curve is respected.