Objective To investigate the clinical effect of arthroscopy-assisted small incision repair for rotator cuff tears. Methods Twenty-two cases of rotator cuff tears were treated with arthroscopy-assisted small-incision repair from March 1999 to March 2004. 13 cases were treated with arthroscopy, small-incision subacromial gap decompression and rotator cuff repair; 9 cases were treated with arthroscopic subacromial gap decompression and small-incision rotator cuff repair. The UCLA shoulder score criteria were used for evaluation. Results Twenty-two cases were followed up from 1 to 6 years, with a mean of 47 months, and the UCLA score increased from preoperative (14.8±3.8) to postoperative (32.0±4.7) (t=15.086,P=0.000). Excellent in 7 cases, good in 13 cases, acceptable in 1 case, and poor in 1 case; 20 cases were satisfactory. Conclusion Arthroscopy-assisted small incision repair is an effective method for the treatment of rotator cuff tears with simple operation and little trauma.