OBJECTIVE: MRI has proven to be a helpful tool in the detection and description of pathologic changes of the rotator cuff, biceps tendon, and glenoid labrum and has thus become a mainstay in the evaluation of patients with shoulder pain. This review seeks to illustrate some of the more subtle abnormalities that can be detected on shoulder MRI and to highlight some normal anatomic variants that may mimic pathologic processes, concentrating on structures at the anterior superior aspect of the shoulder. CONCLUSION: Shoulder MRI can provide a very accurate evaluation of shoulder pathologic processes and can assist in elucidating abnormalities that can be difficult to diagnose clinically. Awareness of the known anatomic variants and the sometimes subtle potential pain generators at the anterior superior aspect of the shoulder will allow a more accurate interpretation and can therefore increase the diagnostic yield of shoulder MRI.