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Background and purpose Different results after shoulder arthroplasty have been found for different diagnostic groups. We evaluated function, pain, and quality of life after shoulder arthroplasty in 4 diagnostic groups. Patients and methods Patients with shoulder arthroplasties registered in the Norwegian Arthroplasty Register from 1994 through 2008 were posted a questionnaire in 2010. 1,107 patients with rheumatoid arthritis (RA), osteoarthritis (OA), acute fracture (AF), or fracture sequela (FS) returned completed forms (65% response rate). The primary outcome measure was the Oxford shoulder score (OSS), which assesses symptoms and function experienced by the patient on a scale from 0 to 48. A secondary outcome measure was the EQ-5D, which assesses life quality. The patients completed a questionnaire concerning symptoms 1 month before surgery, and another concerning the month before they received the questionnaire. Results Patients with RA and OA had the best results with a mean improvement in OSS of 16 units, as opposed to 11 for FS patients. Both shoulder pain and function had improved substantially. The change in OSS for patients with AF was negative (-11), but similar end results were obtained for AF patients as for RA and OA patients. Quality of life had improved in patients with RA, OA, and FS. Interpretation Good results in terms of pain relief and improved level of function were obtained after shoulder arthroplasty for patients with RA, OA, and-to a lesser degree-FS. A shoulder arthropathy had a major effect on quality of life, and treatment with shoulder replacement substantially improved it. [ABSTRACT FROM AUTHOR]