Arthroscopic rotator cuff repair is an increasingly prevalent procedure. Maximizing postoperative outcomes is directly dependent on the integrity of the surgical fixation of tendon-to-bone. Double-row repair utilizes 2 rows of suture anchor fixation of tendon-to-bone: 1 row medially near the articular margin of the humeral head, and a second row laterally near the greater tuberosity. Among the biomechanical and biophysical benefits of double-row repair (as compared with single-row repair) are: a more anatomic footprint reconstruction, decreased strain and increased stiffness across the repair, smaller gap formation and “dog ear deformities,” and a more encouraging healing environment. Furthermore, the clinical and radiographic benefits of double-row repair are improved functional outcome scores and decreased retear rates.