Spinoglenoid notch cysts were identified by magnetic resonance imaging in 73 patients. Posterosuperior labral tears were identified in 65 patients who had spinoglenoid notch cysts. Patient follow-up was available on 88% of patients at a mean of 20.5 months after treatment. There were 52 men and 11 women, with a mean age of 39 years (range, 19-76 years). All patients reported shoulder pain. Infraspinatus atrophy occurred in 25 patients, weakness with external rotation in 43, and posterior shoulder tenderness in 30. Nineteen patients underwent nonoperative management of the cyst (group I). Eleven underwent attempted needle aspiration of the cyst (group II). Six had isolated arthroscopic treatment of a labral defect with no cyst excision (group III). Twenty-seven were treated with surgical cyst excision with the cyst and superior labral tear fixed arthroscopically or with an open approach in various combinations (group IV). Of the patients, 53% were satisfied in group I, 64% in group II, 67% in group III, and 97% in group IV.