Rotator cuff debridement for complete tears of the rotator cuff fell into disfavor in the mid 1990’s, as arthroscopic repair became more common. Recent anatomic studies have shown that the vast majority of repairs of large and massive tears show good clinical results despite anatomic failure of the majority of repairs. While heroic techniques have been suggested for large and massive tears, the poor anatomic results suggest that revisiting arthroscopic debridement might be indicated, as the end result might be similar to repair with significantly less morbidity.