The scapulothoracic joint plays a key role in the correct function of the shoulder. A thorough understanding of the anatomy and biomechanics is essential to perform an adequate physical exam that has a vital role in the diagnosis of scapular dyskinesis. Some shoulder problems affect mainly the scapulothoracic joint causing primary scapular dyskinesis. Such is the case when different conditions affect the nerves that innervate the scapular girdle, altering the kinematic pattern of the scapulothoracic joint and often causing severe dysfunction that is difficult to treat. There are also instances in which mechanical alterations in the scapulothoracic joint causes snapping or crepitus. Violent trauma can also severely injure the joint in scapulothoracic dissociation. In other occasions, scapular dyskinesis appears in the context of other shoulder problems such as glenohumeral instability, clavicle fractures, acromioclavicular disorders, and impingement syndrome. In these cases, the true role of scapular involvement as a cause or as the facilitator of consequence of the problem is often not clear, but the dyskinesis needs to be addressed specifically during treatment. In most cases, a proper rehabilitation protocol is the primary therapeutic weapon for scapular dyskinesis management.