Impingement syndrome and osteoarthritis of the acromioclavicular joint often coexist. Failure to address acromioclavicular joint disease can be a common cause of failure in the surgical treatment of impingement syndrome. Arthroscopic treatment of each of these disorders independently yields more favorable results than open procedures. In a patient with both disorders, combined arthroscopic subacromial decompression and resection of the distal end of the clavicle can be accomplished in one procedure. We evaluated the results of combined arthroscopic subacromial decompression and distal clavicle resection in 18 patients who were available for a minimum of 2 years' follow-up (average 32 months). Evaluations both before and after surgery were done using the UCLA Shoulder Rating Scale. Results were good or excellent in 89% of the patients and poor in 11%. The average UCLA pain score improved postoperatively for 16 of the 18 patients, while the scores for function, strength, and flexion improved for all patients.