Glenoid deficiency is a feature of different articular pathologic conditions of the shoulder joint, requiring replacement or revision arthroplasty. Small cavitary or segmental defects can be easily corrected without compromising the autologous bone stock necessary for stable glenoid implantation. However, for larger defects little information is available regarding the optimal reconstruction strategy. Different techniques have been proposed without clear guidelines to direct clinical decision making. This article discusses the importance of careful preoperative evaluation and planning for rational decision making and describes technical aspects of some reconstructive procedures preferred by the authors.