Biceps tenotomy and tenodesis are two techniques to deal with long head biceps tendon pathology. Tenodesis has the benefit of theoretically superior cosmesis, though pain and squeaking at the docking site are potential complications. On the other hand, tenotomy is a simpler technique, albeit with risk of "Popeye" deformity. The authors randomized 34 patients undergoing shoulder arthroscopy to receive tenotomy or tendoesis and assessed pain and functional outcomes. There were no significant differences between the two groups, regardless of cuff repair, at 3 or 24 months.