Objective: To compare the clinical outcomes of arthroscopic Bankart repair and open Bankart repair performed through a posterior axillary approach. Methods: A total of 20 patients who underwent Bankart repair between January 2022 and December 2024 were enrolled and equally divided into two groups (n=10 per group). The open surgery group received Bankart repair via a posterior axillary incision, while the arthroscopic group underwent all-arthroscopic Bankart repair. Clinical outcomes, complications, pain scores, and shoulder function were compared between the two groups. Patient recovery was evaluated using the Visual Analogue Scale (VAS) and the Rowe shoulder scoring system at 6 and 12 months postoperatively. Results: No significant differences were observed in preoperative VAS and Rowe scores between the two groups(P > 0.05). At 6 months postoperatively, the arthroscopic group showed lower VAS scores than the open surgery group (P < 0.01); the rate of excellent-to-good clinical outcomes was higher in the arthroscopic group, while the complication rate was lower than that in the open surgery group (P < 0.05); the Rowe shoulder score was higher in the arthroscopic group than in the open surgery group (P < 0.01).At 12 months postoperatively, VAS scores in the arthroscopic group were slightly lower than those in the open surgery group, with no statistically significant difference (P > 0.05); the rate of excellent-to-good clinical outcomes was slightly higher in the arthroscopic group compared with the reference group, with no statistically significant difference (P > 0.05); the Rowe shoulder score was slightly higher in the arthroscopic group than in the open surgery group, with no statistically significant difference (P > 0.05).Conclusion: Arthroscopic treatment of Bankart lesions offers significant short-term advantages, but outcomes at one year postoperatively are comparable to those of open surgery. The posterior axillary incision is concealed, causes minimal trauma, and is suitable for implementation in primary hospitals.