An irreparable rotator cuff tear refers to a situation where the tear in the rotator cuff is large, and there is significant fatty degeneration and atrophy, making it impossible to suture the torn ends back to the humeral head. Various treatment options, including tendon transfer procedures, can be considered in such cases. Tendon transfer may be chosen for younger and active patients, and the selection should consider the advantages and disadvantages, the characteristics of different tendon transfer techniques and the condition of the rotator cuff.The lack of established standard treatment guidelines highlights the need for, further research and clinical experience. Future studies will be needed to establish the effectiveness and safety of treatments, and efforts should be made to improve treatment methods and ensure appropriate patient selection.