As the incidence of shoulder arthroplasty continues to rise, encountering significant glenoid bone loss in the primary and revision setting is becoming a common occurrence. To effectively treat these difficult scenarios, surgeons must understand the common patterns of glenoid bone loss and be aware of the various techniques available for treatment. Understanding bone loss requires careful pre-operative evaluation with appropriate imaging and pre-operative planning software. Treatment algorithms consist of primary anatomic and reverse arthroplasty as well as the use of allograft or autograft bone grafting, augmented glenoid components, specialized surgical techniques, or custom implant designs. Ultimately, good outcomes are able to be obtained with various techniques when applied to the appropriate clinical situation.