The surgical treatment of anterior shoulder instability can present a dilemma. Historically, an open Bankart repair was the benchmark solution. Over the last decade as surgeons became more arthroscopically savvy, the pendulum swung and a paradigm shift occurred. However, more recent studies have challenged this trend and, subsequently, revived interest in open repair. Thus, we feel it is critical to provide a more contemporary stepwise description of a procedure that has become essentially abandoned. The goal is to provide tips and pearls to achieve optimal exposure and, ultimately, a robust repair for a notoriously challenging operation.