Arthroscopy is increasingly being used to manage a wide range of pathologies in the pediatric population. Knee arthroscopy is an efficacious treatment method for skeletally immature patients, and an increasing number of shoulder conditions can be managed with minimally invasive techniques. Special considerations are needed with regard to anatomy, anesthetic technique, equipment, and patient positioning when performing shoulder arthroscopy in a child or an adolescent. Several shoulder ailments can be managed arthroscopically in this patient population, including infection, contractures resulting from brachial plexus palsy, traumatic instability, atraumatic multidirectional instability, hemophilia, and rotator cuff injuries.