For about thirty years, percutaneous irrigation under ultrasound guidance has been used as a means to treat calcific tendinopathy of the shoulder. This technique, performed by MD’s, involves the use of one or two needles to de-compose and dissolve the calcification. In this article, we describe the procedure, at the same time highlighting the need for a complete approach to the pathology. The removal of the calcification is simply the first, albeit most important, step. It must be followed by treatment of the shoulder dysfunctions.