Shoulder pain is a common complaint amongst tennis players. The anatomy of the shoulder girdle is complex and defining the exact pathology that accounts for shoulder pain in tennis players can be difficult. Impingement syndrome and glenohumeral instability are the 2 most common causes of shoulder pain in tennis players. Tennis players with impingement syndrome typically present with pain, especially during overhead strokes and serves. The impingement test helps to confirm the diagnosis. Treatment focuses on restoring any motion and strength deficits and anterior acromioplasty with repair of rotator cuff tears for patients who do not respond to nonoperative care. Tennis players with instability present with pain and a sensation of shoulder 'slipping'. Treatment emphasises rotator cuff and scapular muscle strengthening and surgical stabilisation of the capsulo-labral complex for patients who fail a rehabilitation programme. Prevention of injury in tennis players depends on maintaining flexibility, strength and synchrony among the glenohumeral and scapular muscles.