Open bone block procedures for glenohumeral stabilization have been used for a long time in different variations. Recently published clinical and radiological studies were able to demonstrate that anatomical reconstruction of the glenoid concavity using a pre-shaped iliac crest autograft represents an effective and durable treatment option for bony-mediated anterior shoulder instability. With the advancement of arthroscopic techniques and the development of sophisticated instruments and implants apposition of the bone block can now be performed via an all-arthroscopic approach. This article describes the history, principles, indications, surgical technique and early results of the all-arthroscopic iliac crest bone block procedure.