The "hemiplegic shoulder" connotes subluxation, loss of function, and pain. While 80% of hemiplegic patients experience this problem, 1 its causes are elusive. The neurological damage associated with stroke cannot be solely responsible, as patients with other major neurological insults usually do not encounter this syndrome nor do 20% of hemiplegic patients. The purpose of this paper is to analyze some of the factors leading to the development of the hemiplegic shoulder, to assess such components, and to suggest management strategies to help decrease the negative signs and symptoms.