CASE: Chronic massive irreparable rotator cuff tears remain challenging to treat. We present the case of a 70-year-old active and healthy woman who presented with 6 months of worsening shoulder pain and function; she had experienced considerable deterioration over the past 2 months. Nonoperative management of the massive rotator cuff tear was not successful. Superior capsule reconstruction (SCR) was performed with a partial rotator cuff repair. CONCLUSION: SCR is an exciting advancement for the chronic massive irreparable rotator cuff tear, one of the more challenging problems encountered by shoulder surgeons. Our patient was doing well at the 1-year follow-up and was very satisfied with the outcome.