We report a case of gluteus medius tear in a patient who presented with an 11-month history of severe trochanteric pain. Neither magnetic resonance imaging nor ultrasonography visualized the tear, the only findings being inflammatory thickening of the tendon and bursitis. A glucocorticoid injection into the bursa under fluoroscopic guidance and three glucocorticoid injections at the contact of the tendon failed to relieve the pain. At surgery, a 2 × 4 cm tear was found in the tendon of the right gluteus medius muscle. Partial tendon reconstruction was followed by prompt and lasting pain relief, in accordance with the few similar reports in the literature. This paucity of publications is in sharp contrast with hip fracture surgery findings, suggesting that at least 10% of patients older than 60 years of age may have painless hip rotator cuff tears.