Background: The Danish Shoulder Arthroplasty Registry (DSR) was established in 2004. The purpose of the registry is to monitor and improve the outcome of shoulder arthroplasty surgery in Denmark. Objectives: The objective of this study was to describe the organization of the DSR and review published DSR papers with a special focus on patients with osteoarthritis. Methods: All Danish public and private hospitals report to the DSR. Since 2006, when reporting became mandatory, the completeness of reporting has been over 90% each year. Surgeons report patient and operative data electronically at the time of the operation. The Western Ontario Osteoarthritis of the Shoulder (WOOS) index at 1 year is used as patient-reported outcome. A revision is defined as removal or exchange of any component or the addition of a glenoid component. The revision is linked to the primary procedure with use of a unique civil registration number, which is given to all Danish citizens at birth. Results: The registry has published five papers focusing on patients with osteoarthritis. The WOOS score was significantly higher after anatomical total shoulder arthroplasty compared with hemiarthroplasty. The WOOS score after resurfacing hemiarthroplasty varied and was often disappointing especially in young patients. The WOOS score after revision arthroplasty for failed resurfacing hemiarthroplasty was low and disappointing. The short- and mid-term survival rates of anatomical total shoulder arthroplasty were high for both the stemmed and the stemless humeral components. Conclusion: The DSR has recorded significant changes in Danish surgeons’ approach to patients with osteoarthritis. Today, anatomical total shoulder arthroplasty with either a stemmed or a stemless humeral component is preferred in most cases.