Shoulder pain is a common problem following stroke. Patients may present with varying degrees of paralysis (hemiplegia), which commonly affects the arm. As a consequence, the stability of the shoulder may be compromised with subsequent risk of damage to soft tissue structures. Patients with more severe paralysis of the arm are increasingly likely to develop shoulder pain. The underlying causes of shoulder pain, and the sources of this pain, have been the subject of debate and research for many years. There is recent evidence to suggest that damage to soft tissues can occur during post-stroke care in hospital. An evidence-based, multidisciplinary approach should be used to prevent damage to the shoulder and enable management of any complications that arise.