Objectives: To compare the clinical efficiency of tenodesis vs tenotomy in the repair of rotator cuff tear concomitant with long head of biceps tendon (LHBT) injury. Methods: A total of 18 middle-aged and elderly patients having rotator cuff tear concomitant with LBHT injury, from May 2018 to November 2019 were retrospectively analyzed in our hospital. 8 cases were treated with tenodesis (group A) while,10 cases were treated tenotomy (Group B). Postoperative evaluation of the shoulder joint was assessed by VAS pain score, American Shoulder and Elbow Surgery Scoring System (ASES) score, the incidence of Popeye deformity, the active and passive range of motion (ROM) of the shoulder joint and the changes in the strength of the upper limb muscle. The average postoperative follow-up period of two groups were 20.6 months (14-31months) and 22.4 months (12-32 months), respectively. Results: The VAS score was 5.9±1.3 preoperatively and 1.0±0.7 postoperatively in group A, 6.3±0.96 preoperatively and 0.7±0.56 postoperatively in group B. ASES was 46.4±11.0 and 93.8±4.8 in group A, 49.5±8.3 and 92.1±5.8 in group B respectively. The pre-and post-operative VAS and ASES scores were significantly different in each group(p<0.01). The postoperative VAS and ASES scores were no difference in the two groups(p>0.05). One patient suffered from Popeye deformity in group B (p>0.05). The biceps strength of all the patients was found to be Grade V. The ROM was no limitation. Conclusion: The arthroscopic tenodesis and tenotomy are safe and reliable options in the repair of rotator cuff tear associated with long head of biceps tendon (LHBT) injury. While in tenotomy, there could be a risk of Popeye deformity, however, further studies with a larger sample size and longer follow-up are warranted for clarification.