One hundred and eight patients with recurrent anterior shoulder instability with the presence of an engaging Hill-Sachs defect were randomized to receive an arthroscopic Bankart repair with remplissage (n=54) or without remplissage (n=54). The primary outcome of interest was the Western Ontario Shoulder Instability Score (WOSI). Secondary outcomes of interest included incidence of revision surgery and recurrent instability, the American Shoulder and Elbow Surgeons (ASES) score, the Simple Shoulder Test (SST) scores, range of motion and incidence of complications. Follow-up was performed up to 2 years post-operation. Results revealed significantly favourable WOSI scores at 3 months in the no remplissage group compared to the remplissage group. Additionally, the incidence of recurrent instability and revision were significantly lower in the remplissage group. Patient reported outcomes, range of motion, and shoulder function scores were similar between groups at 24 months.