• Asymptomatic rotator cuff tears (RCTs) are prevalent in the general population; they are positively associated with age and are common in the contralateral shoulder of individuals who are being treated for shoulder pain or a symptomatic RCT. • Asymptomatic RCTs are likely to become symptomatic over time, corresponding with decreased patient-reported function, strength, and range of motion. • Previous studies have largely reported inconsistent findings regarding patient-reported outcomes, strength, range of motion, and kinematics in individuals with asymptomatic RCTs. • Future research would benefit from characterizing any functional alteration that is associated with asymptomatic rotator cuff pathology, including determining whether such alterations are detrimental or compensatory and understanding the mechanism by which an asymptomatic RCT becomes symptomatic. Rotator cuff tears (RCTs) are common, affecting approximately 40% of the population who are >60 years of age 1-3 and substantially impacting an individual's function 4,5. Approximately 250,000 rotator cuff repairs are performed annually in the United States 6 , accounting for $3 to $5 billion per year in medical costs, Workers' Compensation benefits, and lost productivity 7,8. The rotator cuff has received considerable research attention over the last 30 to 40 years (Fig. 1), and these efforts have contributed greatly to our knowledge regarding the spectrum of rotator cuff pathology. For example, previous research has documented RCT risk factors 3,9-12 , natural history 13-17 , clinical imaging considerations 18 , and outcomes of nonsurgical 19-21 and surgical 22-24 interventions. Despite an increase over time in our understanding of the healthy and the pathologic rotator cuff and the advances in surgical repair techniques, a recent review by McElvany et al. concluded that clinical outcomes after rotator cuff repair have not improved appreciably over the last 30 years 25 .