Rotator cuff (RC) repair leads to less than optimal results when dealing with massive lesions, so the use of scaffolds as biological support has been proposed to improve RC repair site biology. The present study aims to evaluate the clinical and radiographical outcomes in a series of patients suffering from massive or irreparable RC tears treated with patch (porcine or human scaffolds) repair (augmentation or bridging). Twenty-three patients with a minimum follow up of 24 months were subjectively with 3 patient-related outcome measurements (PROMs) (American Shoulder and Elbow Surgeons score, Constant score, visual analog scale), clinically and radiographically assessed before and after surgery. Regardless the technique (augmentation or bridging) or type of scaffold (porcine or human) employed, at follow up all patients experienced a statistically signif-icant improvement in all PROMs, and clinically. Patch repair represents a valid salvage procedure in massive or irreparable RC tears improving the quality of life and eventually delaying the need for prosthetic replacement.