As wireless networks evolve from 4G/LTE to 5G, small cells will play a critical role in delivering the high bandwidth, low-latency connections required by the myriad potential 5G use cases. With regulators opening up new low, mid and high-band millimeter wave (mmWave) spectrum for 5G, MSOs are uniquely positioned to create ultra-dense 5G wireless networks by leveraging their existing hybrid fibercoax (HFC) networks and emerging technologies such as full duplex DOCSIS (FDX) and distributed access architectures (DAA). This paper examines the drivers for the adoption of 5G and the potential opportunities and challenges presented by 5G small cells based on insights from Shaw Communications’ recent deployments of 4G/LTE small cells, through its subsidiary Freedom Mobile.