Objective: to analyze the efficacy of arthroscopic surgical treatment and conservative treatment of sports rotator cuff injury. Methods: 100 patients with sports rotator cuff injury treated in our hospital from May 2016 to November 2020 were randomly divided into experimental group and control group, with 50 cases in each group. The control group was treated conservatively, and the experimental group was treated with arthroscopic surgery. The curative effects of the two groups were compared. Results: after 4 weeks, 8 weeks and 3 months of treatment, the complication rate of the experimental group were lower than those of the control group; The excellent and good rate, constant Murley score, QOL score, UCLA score, flexion lift, abduction lift, external rotation and internal rotation angles of the experimental group were higher than those of the control group (P < 0.05). The activity of the affected side in the experimental group was close to that of the healthy side. Conclusion: Compared with conservative treatment, arthroscopic surgery for sports rotator cuff injury has definite effect, reduces pain and complications, can effectively improve the patient""s condition, improve the patient""s shoulder function and quality of life, which is worth popularizing and applying.