The successful outcomes of Total Shoulder Arthroplasty are well documented but lack of sufficient glenoid bone stock represents a major challenge in complex primary and revision arthroplasty procedures. Techniques have been advocated and new innovations are rapidly developing to address these issues. This article will describe the practicalities of these techniques and present an algorithm for addressing the issues, taking into account the useable limits of the current standard implants into the expanding availability of patient specific instrumentation and bespoke implants.