Abstract:The techniques of shoulder arthroscopy and shoulder surgery for shoulder disorders and injuries has been developing rapid- ly in recent years. As some clinicians pay more attention to surgical technique itself, while ignore to accurate clinical diagnosis; expand the surgical indication without comprehensive master of required skill, the missed diagnosis, misdiagnosis and mistreatment happened frequent- ly in some extent. Therefore, it is necessary to discuss the pitfalls in shoulder arthroscopy and shoulder surgery deeply. In this issue of Or- thopedic Journal of China, the complications and adverse events in the diagnosis and treatment of shoulder disease and injury were ana- lyzed, involving shoulder instability, shoulder fracture dislocation complicated with injuries to blood vessels and nerve, shoulder dislocation complicated with rotator cuff tear, labral tear, infection, instability secondary to syringomyelia. Furthermore, relevant factors are searched re- garding to the occurrence of recurrent shoulder instability, re-torn rotator cuff, unstable anchor fixation, failure of Latarjet procedure, and complications of internal fixation of shoulder fractures. Moreover, the nursing and rehabilitation, as well as relative basic researches are dis- cussed regarding abovementioned dilemmas, in order to remind the large number of clinicians to caution the mistakes and pitfalls in clini- cal practice of shoulder arthroscopy and surgery to prevent adverse consequences. In addition, this article also proposed some suggestions, including strengthening the clinical training to reduce misdiagnosis and missed diagnosis, executing the operation indications to avoid com- plications, paying attention to innovation and new technology development to avoid surgical technique "show"; enhancing continuing educa- tion to improve the level of diagnosis and treatment, and follow the concept of function first.