The subscapularis (SSC) muscle, one of the four rotator cuff (RC) muscles, plays a crucial role in balancing and moving the shoulder. Cases of irreparable SSC tears are difficult entities within shoulder surgery. Different techniques have been suggested with different outcomes but with no golden standard these days. Musculotendinous transfers, anterior capsular reconstruction (ACR), shoulder arthroplasty and even arthrodesis are the current options available. This article provides a review of existing literature on this entity, covering clinical work-up, operative possibilities, techniques, and rehabilitation.