50 patients with rotator cuff tear and concomitant long head of the biceps (LHB) tendinopathy were randomized to arthroscopic tenodesis either with or without release of the transverse humeral ligament. The purpose of this study was to compare visual analog scale pain score, Constant score, and LHB score between the two groups over 24 months follow-up. Findings indicated significantly higher Constant score and LHB score with release of the transverse humeral ligament in comparison to without transverse humeral ligament release. No significant differences were reported for intermediate postoperative pain.