Arthroscopic repair of rotator cuff tears has become popular with the advancement in technology and arthroscopic technique. As we attempt to arthroscopically repair larger rotator cuff tears, we are relying more on tissue fixation. The tendon-suture interface has been recognized as the weak link in rotator cuff repair. In this article, we propose the use of the Mac stitch--a simple modification of suture placement, a combination of a horizontal and vertical loop at the site of repair--to increase the strength of tissue fixation. The Mac stitch is a simple arthroscopic stitch that can be used for small and massive rotator cuff repairs.