To clarify the effect of surgical treatment for the “painful throwing shoulder syndrome”, we studied 80 throwing or overhand athletes who were followed up for at least 1 year ( mean: 31 months )postoperatively. The mean age at the time of operation was 22 years ( 13-53 ), and the sport was baseball in 59 cases, volleyball in 7 cases, tennis in 6 cases, and some other sport in 8 cases. The diagnosis at the time of operation was the impingement syndrome in 44 cases, a labral tear in 19cases, anterior subluxation in 10 cases, posterior subluxation in 3 cases, multidirectional instability in 2 cases, and other in 2 cases. Intraarticular procedures were performed in a total of 62 cases, including arthroscopic debridement in 33 cases, stapling in 26 cases, open capsulorrhaphy in 6 cases, modified Bristow's method in 3 cases, and other in 3 cases. Open or arthroscopic subacromial decompression was performed on 46 patients. In 28 of these cases, the afore-mentioned intraarticular procedures were performed in combination. An improvement in pain during throwing or overhand action was observed in 68 cases ( 85 % ).61 patients ( 77 % ) were able to return to playing sport, but only 4 out of 15 pitchers ( 27 % ) were able to return to their previous level of pitching. The reasons for these unfavorable results were thought to be problems with the diagnosis ( especially, with the evaluation of instability ), the indications for surgery, and the surgical techniques, but there are still many points which remain to be clarified. In order to improve the results, along with elucidating the pathology of a “painful throwing shoulder” it is also necessary to develop more physiological and anatomical reconstruction techniques.