100 patients with rotator cuff tears in addition to asymptomatic acromioclavicular joint arthritis were randomly assigned to undergo rotator cuff repair with arthroscopic distal clavicle resection or repair alone. Clinical, functional, and radiographic outcomes were evaluated at a minimum of 24 months postoperatively. Findings revealed similar improvements using both techniques; however, there were no significant between-group differences at final follow-up. Two patients who underwent distal clavicle resection experienced adverse events: 2 acromioclavicular joint subluxation and tenderness and gross protrusion.