Background: Rotator cuff repair is widely used to treat rotator cuff tear, but its impact on the psychological status in patients with rotator cuff tears and insomnia is still poorly understood.Methods: 240 patients were enrolled who underwent rotator cuff repair at the first affiliated hospital of soochow university from 2014-2018. During the 2-year follow-up period, the patients were assessed preoperatively and postoperatively at 3 months, 6 months, 12 months and 24 months by using Constant, Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), American Shoulder and Elbow Surgeons’ Scale (ASES), Hospital Anxiety and Depression Scale, depression subsection (HADS-D), Hospital Anxiety and Depression Scale, anxiety subsection (HADS-A), and World Health Organization Quality-of-life Scale Abbreviated Version (WHOQOL-BREF).Results: Finally, a total of 240 patients were enrolled in this study and finished the 2 year follow-up.There were 107 men(43.8%) and 133 women(56.2%), and the mean age of the patients was 54.2±7.5 years. With the prolongation of postoperative time, pain, activity of daily life, joint mobility and muscle strength were gradually improved from 4.8 ± 2.2, 7.2 ± 3.4, 14.2 ± 5.5, 7.8 ± 3.5, and 34.0 ± 11.3, respectively, before surgery to 13.2 ± 3.2, 17.8 ± 2.8, 34.0 ± 6.4, 21.0 ± 4.0, and 85.9 ± 12.4, at 2 years after surgery, which was statistically significant (P < 0.001).The scores of ASES and WHOQOL-BREF also increased significantly from 40.5 ± 9.6, 58.3 ± 8.6 before operation to 87.7 ± 10.2, 69.3 ± 7.9 at two years after operation (P < 0.001). HADS-A decreased linearly from 4.8±2.4 before operation to 1.4 ± 1.2 at two years after operation (P < 0.01). The pain scores had a highly positive correlation with the Constant and the ASES scores. The PSQI and the ISI scores had a positive correlation with the HADS-A scores.Conclusion: For the patients with rotator cuff tears and insomnia, rotator cuff repair may contribute to the improvement of clinical outcome and status of anxiety.