Rotator cuff tears in overhead athletes can take on several different forms. Identification of symptomatic rotator cuff disease can be challenging in the overhead athlete as abnormalities of the rotator cuff can be seen commonly in asymptomatic throwers and rotator cuff pathologic conditions often occur in conjunction with other injuries. Partial-thickness tears treated with arthroscopic debridement and management of concomitant pathologic conditions appear to have fairly good outcomes in the literature with most athletes able to return to activity at their preinjury level. Full-thickness tears, however, have fared much more poorly in the overhead athlete with largely dismal outcomes after surgical repair.