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Shoulder arthroplasty is an increasingly commonly performed procedure that achieves excellent functional outcomes and ameliorates pain in the majority. In preparing for a shoulder arthroplasty it is vital that the surgeon makes assessment of a number of factors. These factors are discussed and as to which of these determine the outcome. There are patient specific factors, such as the degree of joint and soft tissue damage, the presence of bone loss, the type of arthritis present and any co-morbidities. The type of prosthesis selected also can influence outcome. The surgical technique and ongoing care and rehabilitation considerations will affect the patient satisfaction. The planning for surgery is enhanced by the use of imaging and technology.