Rotator cuff repair is a common orthopedic procedure. Techniques have evolved from open procedures to an arthroscopic (assisted) procedure in many patients. Tendon healing is anticipated, but complications may occur. There is approximately 90% patient satisfaction with index surgery, but imaging studies reveal defect recurrence in approximately one-third of the larger tears. For patients who are limited by pain, revision surgery is considered. Newer techniques of stabilizing the damaged structures, combined with delay in rehabilitation, improved the number of successful surgeries. Revision surgery for pain relief is promising when causes of persistent pain have been identified. Strength deficits may persist, particularly if permanent atrophy and fatty infiltration within the cuff muscles are demonstrated preoperatively.