Twelve studies investigating outcome following concurrent rotator cuff repair (RCR) and the long head of the biceps (LHB) tenotomy or tenodesis were included in this meta-analysis and systematic review. Three comparative studies were available for meta-analysis. Pooled analyses of comparative studies demonstrated significantly higher postoperative Constant scores following tenodesis versus tenotomy of the long head of the biceps, as well as a significant lower rate of biceps deformity. Pooled analyses of incidences of biceps cramping and patient satisfaction demonstrated no significant differences between tenodesis and tenotomy.