Computed tomography (CT) of the shoulder plays a critical role in diagnosing and evaluating a variety of disorders. CT provides high-resolution images that enable detailed visualization of bony structures, soft tissues, and complex anatomical relationships. CT is particularly valuable in assessing fractures, dislocations, osteoarthritis, and post-traumatic deformities, as well as for preoperative planning in shoulder arthroplasty and post-surgical evaluation. Advanced techniques, such as 3D reconstructions, enhance the diagnostic accuracy and allow for precise surgical navigation. With the advent of dual-energy CT and metal artifact reduction techniques, CT imaging has become increasingly effective in evaluating patients with implants or prostheses. While CT offers significant diagnostic advantages, its use must be judicious due to ionizing radiation exposure. CT arthrography (CTA) is a well-established method in evaluating the articular cartilage and the labra of the glenohumeral joint. The application of CTA requires knowledge of indications and limitations as well as the safe injection techniques by the supervising radiologist. CTA is indicated mostly in patients with MR imaging contraindications and in the postoperative painful syndrome where metallic artifacts may downgrade the quality of the images. In addition, CTA is better in showing small cartilage defects due to its higher image resolution. Fluoroscopic-guided joint puncture is still the most commonly used image guidance method, but the role of ultrasound is constantly increasing.