Intraarticular soft tissue damage after first-time, acute shoulder dislocation has been poorly described in the literature. The present study describes 24 cases of first-time anterior shoulder dislocation that all were evaluated under anesthesia and examined via arthroscopy. All shoulders sustaining anterior dislocation show Bankart and Hill-Sachs lesions. They also show anterior instability. The arthroscopic findings were uniform and therefore cannot be used as predictors for future development of recurrent instability.