Several earlier reports have described life – threatening airway obstruction during arthroscopic shoulder surgery performed under regional anesthesia, caused by the leakage of irrigation fluid out of the shoulder joint space into the surrounding soft tissues, neck, pharynx and upper airway. Here, we present the case of a 32- year- old male in whom the use of general anesthesia with endotracheal intubation for shoulder arthroscopy surgery may have protected the patient from a possible fatal complication; he developed fluid accumulation in to the extra-articular soft tissues with subsequent tracheal compression - a very rare complication associated with this surgical technique. We recommend general anesthesia with endotracheal intubation for procedure performed by surgeons without an adequate experience, and periodic neck examination of any patient undergoing arthroscopic shoulder surgery, especially under general anesthesia as anesthetized patients cannot complain of breathing difficulty.