Background: Occupational shoulder injuries are a concern for society and clinicians. To best treat and assess the influence of physical work tasks on shoulder health, it is necessary to first understand shoulder function and dysfunction, common occupational pathologies, and existing methods to assess and prevent work-related shoulder injuries. Objectives: The objectives of this paper are to present fundamental shoulder biomechanics, discuss known occupational risk factors for shoulder injury, review assessment and prevention techniques for shoulder injuries, and describe the range of tools available to evaluate work tasks for potential physical shoulder stressors.Major findings: The complex shoulder mechanism has a unique role for performing work. Recognition of the delicate balance between creating arm mobility and maintaining joint stability is crucial to understanding how the region can be injured during work. Tools exist to aid clinicians in thinking critically about occupational shoulder injury, and can provide information about both specific and general physical exposures. Conclusions: The shoulder is a complicated assembly of many neuromusculoskeletal elements, and these tissues can be injured in a variety of ways. This paper provides background on the nature of these injuries and discusses preventative strategies available to pragmatically assist clinicians.