Complications occur with total shoulder arthroplasty (TSA), and they can be daunting to diagnose and treat. It is important to review common TSA-related complications and to summarize risk factors along with causes of these complications and how to avoid them. The orthopaedic surgeon should be knowledgeable about how to successfully manage complications to achieve good patient outcomes and the etiologies and management of the painful and stiff shoulder arthroplasty, subscapularis failure after anatomic TSA, instability after reverse shoulder arthroplasty, and acromion stress fractures in the setting of reverse TSA.