The successful treatment of symptomatic chronic, massive irreparable rotator cuff tears remains a difficult problem for many shoulder surgeons. Multiple procedures have been attempted to address this problem including latissimus dorsi transfer, arthroscopic shoulder debridement, and reverse total shoulder arthroplasty. Not every patient is a candidate for the above procedures and those that do undergo one of the above procedures has no guarantee of experiencing clinical improvement. Therefore, many shoulder surgeons have looked toward additional methods to manage the chronic, massive irreparable rotator cuff tear. Acellular human dermal allograft is a "graft" material that we have been using to reliably and successfully restore function to patients with these otherwise irreparable rotator cuff tears.