Background: Outcomes after arthroscopic rotator cuff repair in recreational athletes older than 70 years are not widely reported. Purpose: To evaluate clinical outcomes after arthroscopic repair of full-thickness rotator cuff tears in recreational athletes aged 70 years or older. Study Design: Case series; Level of evidence, 4. Methods: Institutional review board approval was obtained before initiation of this study. Data were collected prospectively and were retrospectively reviewed. From December 2005 to August 2012, patients who were at least 70 years of age, who described themselves as recreational athletes, and who underwent a primary or revision arthroscopic repair of full-thickness supraspinatus tears by a single surgeon were identified from a surgical registry. Demographic data, surgical data, and the following pre- and postoperative clinical outcomes scores were collected: American Shoulder and Elbow Surgeons (ASES), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), Short Form–12 Physical Component Summary (SF-12 PCS), and Single Assessment Numeric Evaluation (SANE). Acromiohumeral distance and Goutallier classifications were recorded. Patient satisfaction (range, 1-10, 10 = best) and reasons for activity modification were collected at final follow-up. Results: Forty-nine shoulders (44 patients) were included. The mean age was 73 years (range, 70-82 years). There were 33 men and 11 women (5 bilateral). The mean preoperative acromiohumeral distance was 9.2 mm (range, 3.0-15.9 mm). All patients had Goutallier classifications of 0, 1, or 2. Mean follow-up was 3.6 years (range, 2.0-6.9 years) in 43 of 49 (88%) shoulders. No rotator cuff repairs were revised, however, 1 patient had surgical treatment for stiffness. All postoperative outcomes measures demonstrated significant improvements when compared with their preoperative baselines. The mean ASES score was 90.3 (range, 60-100), the mean SANE score was 85.1 (range, 29-100), the mean QuickDASH score was 11.3 (0-50), and the mean SF-12 PCS score was 51.6 (range, 38-58) with a median patient satisfaction of 10 (range, 1-10). Patients who modified their recreational activities due to postoperative weakness were significantly less satisfied (P = .018). In this study, 24 of 31 (77%) who responded were able to return to their sport at a similar level of intensity. Conclusion: Arthroscopic rotator cuff repair was highly effective at reducing pain, improving function, and returning patients to sport in recreational athletes 70 years of age and older.