The authors reviewed the clinical results of treatment for the impingement syndrome in 33 patients, 36 cases at the Department of Orthopaedic Surgery, Medical College, Kyung Hee University from November 1989 to March 1992. Follow-up evaluations averaged 23 months. The average age was 49 years old and there were 16 men and 17 women. The right shoulder was involved in 25 cases and the left in 11. The prominent complaint was pain with impaired shoulder function, especially in abduction, external rotation and flexion. The average duration of symptoms was 11 months ranged from 1 month to 7 years. Twenty one cases were managed with conservative therapy only, consisting of rest, physical therapy, analgesic and antiinflammatory drugs. Operation was performed in 15 of 36 cases. Anterior acromioplasty was done in 11 cases and arthroscopic decompression in 4 cases. In all patients with operative management, relief of pain and improvement of shoulder function were obtained and complications were not observed. Average preopperative shoulder rating score was 38.2 and postoperative score was 87. In 14 cases(71%) of conservative management, the symptoms were improved but still persistent in 6 cases(29%). Average initial shoulder rating score was 47 and follow up score was 68.4. In the analysis of above results, operative treatment was effective when symptoms are persistent and fail to respond to conservative management.