Limited treatment options exist for glenohumeral osteoarthritis in a young and active patient. To address the pain and limitation of significant osteoarthritis while avoiding a total shoulder arthroplasty (TSA), we have been using a minimally invasive technique to resurface both the glenoid and the humeral head using osteochondral allografts. After identifying the areas of most severe chondral damage during a diagnostic arthroscopy, a transhumeral tunnel is drilled using a transhumeral guidepin. Through this tunnel the allograft donor sites are prepared by retrograde reaming the humeral head and antegrade reaming the glenoid socket. Allograft constructs are sized and cut intra-operatively on a back table, inserted through the anterior portal and secured into the graft sites using chondral darts for the glenoid and a press fit for the humeral head.