56 patients with a lesion of the long head of the biceps tendon were randomized to either arthroscopic tenodesis or tenotomy. Patients were assessed for patient-reported function, incidences of cramping, cosmetic deformity, and flexion & supination strength over a 12-month follow-up. The primary outcome of the American Shoulder and Elbow Surgeons (ASES) score, as well as secondary outcomes of the Western Ontario Rotator Cuff Index (WORC) and patient-reported pain, did not significantly differ between groups. The only significant difference noted between groups was higher flexion strength at 6 months postoperatively in the tenodesis group compared to the tenotomy group; differences between groups at 12 months for both flexion and supination strength were not significant.