Posterior dislocation is extremely rare; when seen, the clinician should focus on its cause, the most common being extremely vigorous muscle contractions, which may be associated with an epileptic seizure caused by electrocution. Treatment of recurrent instability can be challenging. The aims of treatment are to maintain function and range of movement while preventing instability (subluxation, dislocation, and the “feeling” of dislocation). This can be achieved through physical therapy and shoulder “re-education.” If this fails, capsular tightening and stabilization of the labrum can be achieved arthroscopically. If the problem persists, the coracoid process can be divided at the base, maintaining continuity of the muscular attachments. The process is transferred and a screw fixed to the anterior inferior border of the glenoid to form a buttress to prevent future dislocations.