We investigated the usefulness of non-contrast perfusion obtained using arterial spin labeling (ASL) for the evaluation of various shoulder diseases. In 137 consecutive patients, the subacromial space was divided into four areas, in which ASL enhancement patterns were evaluated. Most of the full thickness tear of rotator cuff demonstrated diffuse enhancement. Most of the adhesive capsulitis showed the anterior area enhancement to be consistent with rotator interval. Acromioclavicular (AC) arthritis showed dominant enhancement in the AC joint. The specific enhancement pattern of ASL is well correlated with the pathology of shoulder diseases, which is highly useful for the differential diagnosis.