A well-functioning scapula provides a stable base for the humerus and allows free motion of the arm through a smooth glide over the posterior thoracic wall. This is possible through intimate interaction between anatomy and muscles. This can be disturbed by painful conditions, nerve dysfunctions, over-/underperformance of muscles, anatomic variations and trauma. In this review, we describe anatomy, biomechanics and different pathologies of the scapula: muscular imbalances, nerve dysfunctions, snapping scapula, tumours and fractures. We discuss, how the different conditions are diagnosed and treated.