Glenoid loosening after total shoulder arthroplasty is a concern that has prompted the use of alternative resurfacing materials, especially in younger patients with glenohumeral arthritis. Meniscal allografts have been used by many shoulder surgeons recently as a biologic interposition graft. It is attached to the glenoid and functions as a spacer and resurfacing material. Used in conjunction with a standard metal prosthesis on the humeral side, it is an alternative type of glenohumeral arthroplasty. The indications, technique, and outcomes for glenoid resurfacing with use of a lateral meniscal allograft are presented here and discussed. Although it is an exciting concept, early results have been quite variable. We feel that the best material for biologic resurfacing of the glenoid and technique for implantation is currently unknown.