A group of patients affected by bone loss in the context of recurrent anterior shoulder instability can be treated arthroscopically with a modified Eden-Hybinette technique. The arthroscopic anterior bone block procedure combines an arthroscopic Bankart repair with the transfer of a bone graft fixed on the glenoid rim positioned with the aid of a posterior glenoid guide. The efficacy of this procedure is related to the bone block effect provided by the bone graft and the concavity re-creation provided by the labral repair and capsular and ligaments shift and repair. The goal of the procedure is to restore the normal anatomy of the unstable shoulder with bone defects. More recently the procedure has been performed with iliac crest allograft and with horse xenograft to avoid donor site pathology. Fixation is achieved with double round endobuttons to avoid screw related complications.