Biceps-labrum complex (BLC) disease is a well recognized source of shoulder pain. The BLC can be divided into 3 anatomical zones: inside, junction, and bicipital tunnel. Despite our evolving understanding, diagnosis of BLC pathology through physical examination, standard imaging techniques, and standard diagnostic glenohumeral arthroscopy can be challenging. Selection of the most appropriate surgical technique in refractory cases should take into account decompression of the extra-articular bicipital tunnel. In this article we review the recent literature regarding diagnosis and treatment options for BLC disease.