[Objective] To compare the clinical outcomes of arthroscopic versus open repairs for recurrent anterior shoulder dislocation in the elderly. [Methods] A retrospective study was conducted on 88 elderly patients, including 35 males and 53 females, aged (65.21± 5.64) years, who underwent surgical treatment for traumatic recurrent anterior dislocation of the shoulder in our hospital from May 2015 to April 2019. According to the results of preoperative doctor-patient communication, 22 patients had the Bankart lesion and rotator cuff tear repaired arthroscopically, while the other 66 patients underwent traditional open repair surgery. [Results] The patients in both groups had operations completed successfully. The arthroscopic group proved significantly superior to the open group in term of operation time, intraop- erative blood loss, postoperative drainage and hospital stay (P＜0.05) . During the follow-up, no further dislocation of shoulder happened in anyone in both groups. The arthroscopic group resumed full weight-bearing activity significantly earlier than the open group (P＜0.05) . The VAS scores decreased significantly (P＜0.05) , while the Neer and Constant-Murley scores increased significantly over time postoperatively in both groups (P＜0.05) . At 6 months after operation and the latest follow-up, the arthroscopic group was significantly superior to the open group regarding VAS, Neer, and Constant-Murley scores (P＜0.05) . [Conclusion] For recurrent anterior shoulder dislocation in the elderly, the arthroscopic technique is better than the open counterpart in term of the clinical results of simultaneous repair of Bankart injury and ro- tator cuff tear.