Sixty-six patients undergoing primary rTSA for rotator cuff tear arthropathy, a massive rotator cuff tear, or primary osteoarthritis with a rotator cuff tear were randomized to receive either the humeral component in neutral version (n=33) or in 30° of retroversion (n=33). The primary outcome of interest was humeral external and internal rotation at 2 years postoperatively. Secondary outcomes included shoulder active range of motion, muscle strength, visual analog scale (VAS) pain scores, American Shoulder and Elbow Surgeons (ASES) scores, and Patient-Reported Outcomes Measurement Information System Global 10 (PROMIS-10) scores. Outcomes were assessed up to 2 years postoperatively. Overall, the results revealed no significant differences between groups in active shoulder motion, muscle strength, pain, or patient-reported outcomes. These findings suggest that humeral component version does not impact clinical outcomes following rTSA.