Massive rotator cuff tears occupy a significant place among all rotator cuff tears. Irreparable rotator cuff tears represent a small proportion of massive rotator cuff tears. It is necessary to distinguish between the massive rotator cuff tear and irreparable rotator cuff tear. The vast majority of massive rotator cuff tears are repairable. Most of the irreparable rotator cuff tears are massive. Tendon transfers have been used for many years in irreparable rotator cuff injuries. Basically, it is used in postero-superior insufficiency, antero-superior insufficiency and in some cases together with reverse shoulder arthroplasty. The latissimus dorsi, lower trapezius, teres major, pectoralis major, and pectoralis minor are the tendons used in the transfer. Functional losses due to rotator cuff tears are basically divided into isolated and combined. The most important factor when planning tendon transfer is to evaluate whether there is a pseudoparalysis. Therefore, it is used in cases where there is an isolated active function. Since combined functional losses cause pseudoparalysis, tendon transfer method is not used in this case.