Arthroscopic rotator cuff repair has shown a high rate of patient satisfaction. Multiple studies, however, have shown significant structural failure rates. Platelet-rich plasma seemed to be a safe, reasonable way to provide growth factors to improve these rates of healing. While preliminary results were encouraging, higher-level studies with longer-term follow-up have not borne out the early enthusiasm for the use of platelet-rich plasma. The reason for this failure is multifactorial, and includes differences in products as prepared, variations in growth factor concentrations both between patients and even day to day in the same patient. Timing and technique of application also remain to be resolved. Although complications have been minimal, the lack of long-term benefit and cost of the material indicate that this material cannot be recommended in its current preparations.