Superior labral lesions are a common occurrence in athletes, but they also are seen in individuals who do not participate in athletics. The diagnosis and treatment of superior labrum anterior and posterior (SLAP) lesions pose a major challenge to anyone who evaluates shoulders, including orthopedic surgeons and rehabilitation specialists. One of the reasons the diagnosis is difficult to ascertain is that there are often coexisting abnormalities that can produce symptoms similar to those of SLAP lesions. Even though improvement in arthroscopic techniques has allowed arthroscopic repair of SLAP lesions with suture anchors, the surgical results, especially in athletes, have not proven to be as successful as once believed. Controversies about which treatment (suture anchor fixation vs. biceps tenodesis) is more appropriate in athletes is the ongoing topic of discussion in SLAP lesions. This chapter reviews the anatomy, classification, pathophysiology, diagnosis, and treatment of SLAP lesions.