Surface replacement arthroplasty of the shoulder offers the ability to restore anatomy and biomechanics of the glenohumeral joint, if sufficient humeral bone stock of at least 60% of the humeral head is preserved and no severe deformity is present. The implantation following the individual anatomy helps to avoid complications such as prosthetic malpositioning and periprosthetic fractures. While the use of a glenoid component is technically demanding, revision to a stem prosthesis is relatively easy because of bone stock preservation. Indications for humeral head resurfacing are osteoarthritis (OA), rheumatoid arthritis (RA), avascular necrosis stages 2-4, and stable forms of cuff tear arthropathy (CTA). Published results for OA and RA are comparable to those obtained with modern modular stem prostheses; the use in CTA appears promising under "limited goals criteria."