Shoulder injuries in football are less common than lower limb injuries, but are often more serious than many other injuries and result in a longer time off play. No study has looked at the types of injuries and their interventions in professional footballers thus far. The aim was to review the serious shoulder injuries sustained in professional football over a period of four competitive seasons. Anonymous data was collected on all shoulder injuries claimed for from all English Premiership Football teams over four seasons. This data only applied to injuries that were claimed on health insurance from professional football clubs in the United Kingdom. It excluded minor injuries that did not require investigations or interventional treatment. There were 40 466 injury claims of which 3.3% were shoulder injuries (1335). This was equivalent to an average of 445 serious shoulder injuries per year. The percentage of shoulder injuries (injuries per year / total shoulder injuries) increased from 35% in the 2006–2007 season to 89% in the 2009–2010 season. There was also a steady increase in the number of MRI scans and injections, but not with MR arthrograms. There was an increase in the number of surgical interventions during the same time period. The vast majority of surgical procedures were arthroscopic stabilisations (26%) and labral repairs (23%). Stabilisations increased from 15% in 07–08 to 39% in 09–10 whereas the percentage of labral repairs has remained unchanged throughout. The incidences of significant shoulder injuries and surgery have increased in professional football. The majority of the surgery has been labral and stabilisation surgery. Further investigation is required to examine the causes for these trends and possible injury reduction.