The significance of glenoid bone loss (GBL) cannot be overstated in regard to recurrence of anterior shoulder instability. Bone loss in anterior shoulder instability is not limited to the glenoid; therefore, in recent years there has been increasing attention to the role of humeral bone loss (Hill-Sachc lesions) on glenohumeral joint stability. The concepts of engaging lesions and glenoid track are ways to evaluate the risk of recurrent instability in cases of bipolar bone loss. Although there is no consensus on critical bone loss, it is apparent that bone loss increases the risk of recurrent instability. The Latarjet procedure is a reliable technique for treating recurrent anterior shoulder instability associated with significant bone loss or a failed Bankart repair procedure. Historically, this procedure was performed as open surgery; however, in recent years, the arthroscopic technique has increased in popularity. The Latarjet procedure is challenging and is associated with some complications, whether performed open or arthroscopically. Both approaches have advantages and disadvantages and will be discussed in this review.