ABSTRACT: OBJECTIVE:To assess the effectiveness of arthroscopic versus mini-open rotator cuff repair on function, pain and range of motion at 3-, 6- and 12-month follow ups. DESIGN:Systematic review and meta-analysis of randomized controlled trials. SETTING:Clinical setting. PARTICIPANTS:Patients 18 years and older with a rotator cuff tear. INTERVENTION/COMPARISON:Arthroscopic/mini-open rotator cuff repair surgery followed by post operative rehabilitation. MAIN OUTCOME MEASURES:Function and pain. RESULTS:Six RCTs (n = 670) were included. The pooled results, demonstrated no significant difference between arthroscopic and mini open approach to rotator cuff repair on function (very low quality, 4 RCTs, 495 patients, SMD 0.00, 3-month; very low quality, 4 RCTs, 495 patients, SMD -0.01, 6-month; very low quality, 3 RCTs, 462 patients, SMD -0.09, 12-months). For pain, the pooled results, were not statistically different between groups (very low quality, 3 RCTs, 254 patients, MD -0.21, 3-month; very low quality, 3 RCTs, 254 patients, MD -0.03, 6-month; very low quality, 2 RCTs, 194 patients, MD -0.35, 12-months). CONCLUSION:The effects of arthroscopic compared to mini-open rotator cuff repair, on function, pain and range of motion are too small to be clinically important at 3-, 6- and 12-month follow ups.