OBJECTIVE. We describe the MR imaging findings of focal articular cartilage lesions of the superior humeral head and the clinical features in seven patients, CONCLUSION. Focal articular cartilage lesions of the superior humeral head are rare lesions that may cause clinical symptoms and may be easily overlooked on MR imaging, These lesions occur in a particular location (along the superior surface of the posterior humeral head, medial to the expected location of a Hill-Sachs: lesion), are caused by trauma, and do not seem to have a specific mechanism of injury. Because of improvements in MR imaging of cartilage, this area of the shoulder should be inspected for this lesion.