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Arthroscopically assisted or mini-open repair has become a popular method of treating full-thickness tears of the rotator cuff. This technique combines an arthroscopic subacromial decompression with an open tendon repair using a small deltoid split approach. The deltoid origin is preserved because the anterior acromioplasty is performed arthroscopically. The mini-open technique integrates arthroscopic and open methods for the optimal treatment of rotator cuff tears. This article presents the indications, technique, and results of the mini-open technique.