Tashjian RZ, et al. - A total of 22 patients underwent primary or revision reverse total shoulder arthroplasty (RTSA) with structural glenoid allografting to assess the clinical and radiographic outcomes of RTSA with concomitant structural allografting to reconstruct large glenoid defects. From preoperatively to postoperatively, notable betterments in the average Simple Shoulder Test score, the average American Shoulder and Elbow Surgeons score, and average active forward elevation were recorded. Postoperatively, 14 of 17 patients with a minimum 1-year radiographic follow-up, had complete radiographic inclusion of the graft. Acromial fracture nonunions emerged in two individuals and loosening and migration of the baseplate were observed in two individuals, however, no patients chose to undergo further surgery. Thus, RTSA with allograft reconstruction of severe glenoid defects permits the refurbishment of glenoid anatomy and results in high rates of bony incorporation with low rates of glenoid loosening or necessary for revision. In revision RTSA, The structural allograft is an excellent option to autograft to circumvent graft-site morbidity.