Posterior shoulder dislocations often are associated with an impression fracture involving the anterior humeral head, which is known as a reverse Hill-Sachs lesion. These injuries may result in considerable bone defects that require surgical management to prevent engagement with the posterior glenoid. This video presents an arthroscopic, knotless modified McLaughlin procedure for the management of small to medium sized engaging Hill-Sachs lesions. The knotless technique aims to eliminate potential complications associated with knot tying, such as knot migration, knot impingement, and chondral abrasion.