Shared decision-making in orthopaedic surgery involves an honest and open discussion between the surgeon and patient concerning the treatment options (including no treatment) and the risks and rewards of each option. This includes a frank discussion of the potential complications of surgery and this often creates a conundrum for the patient – surgery may only offer pain relief and improved function but the list of potential complications seems endless. However the discussion of complications can itself be problematic – most are rare and the surgeon may have little or no experience of them, or at least insufficient to give the patient their own personal figures in percentage terms. An overview of the literature is helpful but, as this article will discuss, the data published can only be a guide. It is incumbent on all surgeons to consider their own skills, setting, access to equipment and technologies and the team they work with to develop an effective consent process that fully informs patients and helps them to make their choice comfortably. Data are discussed that aid the surgeon in developing their own personalized process for discussing the potential complications of shoulder surgery with their patients.