Glenohumeral instability in pediatric and adolescent patients covers a wide range of disease, from traumatic anterior instability to multidirectional instability. The rates of recurrent instability are high. Conservative and operative treatment options have shown variable success. Given the high risk of recurrent instability, young, active patients who seek to return to competitive contact sports should consider arthroscopic stabilization after a first-time instability event. Multidirectional instability should be treated initially with conservative rehabilitation. Patients who fail extensive conservative treatment may benefit from surgical stabilization. Arthroscopic techniques may approach the results of traditional open capsular shift procedures.