Post-operative pain is well recognised in patients undergoing shoulder surgery. With the recent advances in arthroscopic shoulder surgery over the last decade, a larger number of cases are being performed in day surgery units. These procedures are generally performed under general anaesthetic with either an interscalene or suprascapular nerve block or local anaesthetic infiltration. The aim of our prospective audit was to investigate the adequacy of analgesia provided for patients, undergoing day case arthroscopic shoulder procedures in a rural district general hospital, to ensure best medical care and to tailor certain procedures to appropriate analgesic pathways in the future. Fifty consecutive patients, who underwent day case arthroscopic shoulder surgery, were contacted by telephone one week post surgery, to assess their post-operative pain scores and analgesic requirements. Patients who received a nerve block were found to have a significantly longer duration of pain relief (p < 0.001). These patients also had significantly less pain performing their usual activities of daily living in the immediate post-operative period (p = 0.05), compared to patients who only had local anaesthetic infiltration. There was no trend found between the type of procedure and post-operative pain scores. Our audit has confirmed that nerve blocks provide longer pain relief, but has also highlighted the need to take into consideration pre-operative pain and pain perception to enable analgesia to be tailored