Seven patients (eight shoulders) with sepsis of the glenohumeral joint were studied clinically and radiographically. Despite the advanced age of the patients, the presence of gram-negative organisms, and multiple risk factors in each patient (including serious chronic underlying diseases), needle drainage and parenteral antibiotics were all that were required for successful management, provided early diagnosis with prompt institution of antibiotics and drainage occurred. Contrast arthrography safely guided therapy and revealed rotator cuff tears in four of six shoulders as well as frequent extra-articular extensions of the disease. A nonleukemic patient with Aeromonas hydrophilia sepsis and arthritis is reported who survived with eradication of infection and preservation of joint function. A poor prognosis for shoulder sepsis is not substantiated.