Rotator cuff tendinosis and tears are common in the population and are likely multifactorial in etiology, involving both intrinsic and extrinsic factors. Multiple causal factors have been described in association with rotator cuff pathology, including vascular, degenerative, traumatic, and anatomic/mechanical factors. The diagnosis is based on the patient’s history and findings on physical examination, supplemented by imaging findings. Radiography and MRI allow detailed depiction of anatomy and disease, while ultrasound provides dynamic evaluation for impingement. Studies on treatment options have favored physiotherapeutic management, at least initially, with specific indications to pursue surgical management.