Shoulder pain, following low back pain and knee pain, is the third most common presenting musculoskeletal complaint in healthcare institutions. The shoulder is affected by a wide spectrum of disorders including rotator cuff pathology, instability, and various types of arthropathies which, if untreated, leads to a common endpoint—osteoarthritis. Imaging strategies involve the use of multimodality imaging to ascertain underlying cause and the stage of shoulder arthritis and, if appropriate, to perform imaging-guided intervention to halt or slow disease progression. Radiographs are usually the first imaging investigation performed to assess the cause of shoulder pain and the severity of the glenohumeral arthritis. Ultrasound and magnetic resonance imaging (MRI), with supplementary use of computed tomography (CT) scan, are commonly employed to investigate rotator cuff-related pathologies, inflammatory, primary and secondary degenerative, crystalline, and other uncommon causes leading to shoulder arthritis. Ultrasound and fluoroscopy are imaging techniques used to perform diagnostic and therapeutic injections as a part of conservative management of shoulder arthritis. The use of conventional CT scan is reserved for shoulder trauma and preoperative workup for shoulder replacements and for perioperative period to detect complications such as acromion fractures, periprosthetic fractures, and osteolysis where novel metal suppression techniques are often used. Advanced CT technique—dual-energy CT (DECT)—can detect gout noninvasively. Nuclear medicine (NM) scans are rarely used to primarily detect non-tumorous pathologies about the native shoulder joint. These are seldom used to detect infection following shoulder replacement and aseptic loosening. In this chapter, we describe multiple imaging techniques including their principles and uses to detect various shoulder arthritides and describe specific imaging appearances of individual pathologies with an approach to preoperative shoulder imaging.