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Purpose: The purpose of this paper is to clinically evaluate the usefulness of all arthroscopic repair with biceps incorporation in massive sized full thickness rotator cuff tears.Materials and Methods: This is a prospective comparative outcome study evaluating a series of all arthroscopic rotator cuff repairs with biceps incorporation on massive (range: 5~6 cm sized) from March 2003 to May 2006. Group I was twenty two cases of arthroscopically repaired with biceps incorporation, twenty cases of group II without biceps incorporation were analyzed. The average age of the patients was 58 years (range, 41~74 years), and mean follow-up was 24 months (range, 12~36 months). Results were statistically compared by Mann-Whitney test.Results: Average VAS for pain, ADL, UCLA score were not significantly different between group I and group II (P>0.05 for each). Forward elevation strength was 4.3 in group I, 3.5 in group II (P<0.05) . On postoperative follow up ultrasound, retear was 10 cases in the middle of 19 cases at group I, 15 cases in the middle of 17 cases at group II (P<0.05).Conclusion: This study reveals that all arthroscopic repairs with biceps incorporation in massive sized full thickness rotator cuff tears is an effective surgical method and reduced retear and enhanced strength.