Functional outcomes of three surgical treatments for massive rotator cuff repairs were compared. Surgery was performed by a single surgeon (T.W.W.) on 38 patients (mean age: 62.5 years). The surgeon decided which procedure to use for each patient based on tissue quality, ability to mobilize the torn rotator cuff, and degree of tension after the repair was attempted. Twenty-one patients underwent complete repair, 11 underwent partial repair, and 6 had debridement alone. Results were evaluated using the Shoulder Pain and Disability Index and by measuring range of motion and strength. The mean Shoulder Pain and Disability Index score for all patients postoperatively was 25, with subindices averaging 10 for pain and 15 for function. For the subgroups, Shoulder Pain and Disability Index scores for pain and function, were 8 and 10 for complete repair, 11 and 19 for partial repair, and 14 and 24 for debridement alone, respectively. Active external rotation was significantly better (P = .008) postoperatively in patients who had a complete repair compared to debridement alone.