This meta-analysis analyzed eighteen studies (4 randomized clinical trials, 10 non-randomized comparative trials, and 4 observational studies) that compared arthroscopic versus open surgical approaches in treating anterior shoulder instability. Results from the analysis indicated that open techniques were more effective in preventing recurrent instability, and allowed for a faster return to work/sport abilities as compared to arthroscopic approaches. However, arthroscopic methods had higher Rowe Scores (improved function) in the randomized clinical trials.