Glenohumeral arthritis in the young patient presents a difficult problem with potentially devastating sequelae. Reports in the literature suggest a role for arthroscopic treatment in patients with symptomatic degenerative joint disease of the shoulder. However, no published study directly compares patients with unipolar versus bipolar cartilage lesions. We retrospectively reviewed 19 patients (20 shoulders) younger than 55 years with Outerbridge Grade 2-4 articular cartilage changes who underwent arthroscopic glenohumeral débridements. We obtained WOOS, SF-12, SANE and the American Shoulder and Elbow Society scores at last followup. The minimum follow up time was 12 months (average, 20 months; range, 12-33 months). Three patients progressed to shoulder arthroplasty. All but three patients reported their shoulder function at 60% or better based on the SANE score. The grade of the lesion did not influence outcome scores, but patients with unipolar lesions had higher outcome scores than patients with bipolar lesions. We believe arthroscopic glenohumeral débridement in young patients with shoulder arthritis can be an effective tool in managing symptoms and delaying the need for invasive resurfacing or prosthetic replacement.