Arthroscopic rotator cuff repair is a minimally invasive shoulder surgery performed to reattach a torn rotator cuff tendon back to the bone. The rotator cuff is a group of muscles and tendons that stabilize the shoulder and allow the arm to lift and rotate. When one or more of these tendons tear, patients often experience pain with arm elevation, night pain, weakness, and loss of motion. While small or partial tears may respond to non-surgical treatment, moderate to large tears, or tears causing significant functional limitation, often require surgical repair. Before surgery, patients are evaluated to confirm the size, location, and severity of the tear, as well as overall shoulder health. On the day of surgery, the procedure is typically performed as an outpatient operation under general anesthesia, often combined with a regional nerve block to reduce postoperative pain. The surgeon makes several small incisions around the shoulder and inserts an arthroscope, a small camera that allows visualization of the joint without a large incision. Using specialized instruments, the surgeon prepares both the torn tendon and the bone surface where it normally attaches. Suture anchors are then placed into the bone, and stitches from these anchors are passed through the tendon to secure it back to its original attachment site. In many cases, additional procedures are performed at the same time, such as trimming bone that rubs on the tendon or addressing arthritis in the acromioclavicular joint, to reduce future irritation and improve healing conditions. After surgery, the arm is placed in a sling to protect the repair. Patients usually go home the same day. Pain and nighttime discomfort are common early on but are managed with medication and, in some cases, continued local anesthesia. For the first several weeks, shoulder movement is carefully restricted to allow the tendon to heal to the bone. Passive range-of-motion exercises begin early, typically guided by a physiotherapist, but the repaired muscles are not allowed to contract during this phase. Around six weeks after surgery, once initial healing has occurred, the sling is removed and active movement begins under supervision. Strengthening exercises are gradually introduced, with lifting restrictions maintained for several months. Full tendon healing takes approximately six months, and heavy lifting or overhead activity is avoided for six to nine months to reduce the risk of re-tear. Physical therapy often continues for several months, and full pain relief and functional improvement may take up to nine months or longer. Arthroscopic rotator cuff repair has a high success rate, particularly for small to large tears treated early. While the shoulder may not return to “normal,” most patients achieve significant pain relief and meaningful improvement in strength and function. Outcomes depend heavily on tear size, tissue quality, and adherence to rehabilitation, with delayed treatment or very large tears carrying a higher risk of incomplete healing.