129 patients scheduled for biceps tenodesis were randomized to either an arthroscopic proximal approach or open subpectoral approach. The purpose of this study was to compared pain, function, and complications between the two groups. Follow-up was performed for an average of 11.3 months postoperatively. Results demonstrated that patients in both study groups significantly improved from baseline measurements for all clinical outcomes, and that the two surgical techniques did not yield any significant differences. Revision rate was marginally higher for patients in the arthroscopic proximal biceps tenodesis group (8.6%) compared to the open subpectoral tenodesis group (1.4%).