This systematic review examined 8 meta-analyses (4 including Level I evidence and 4 including both Level I and Level II evidence) to determine whether double-row (DR) or single-row (SR) rotator cuff repair (RCR) resulted in superior clinical and structural healing outcomes. The findings of this systematic review of overlapping meta-analyses revealed that the double-row approach results in higher rates of structural healing than the single-row technique, however further research is required to determine whether the advantages associated with the double-row technique is substantial enough to account for the increased cost and operation time required.