Background: Subscapularis tear repair can be achieved through arthroscopic or open surgical techniques. Objectives:The current work aimed to compare the outcomes of both methods in patients with subscapularis tears. Patients and methods: This prospective study included 30 patients with subscapularis tears requiring surgical intervention, conducted at Benha University Hospitals and Ahrar Teaching Hospital from November 2020 to February 2023. Patients were randomly assigned into two groups: Group I (arthroscopic repair, n=15) and Group II (open surgery, n=15). Functional outcomes were assessed using the Simple Shoulder Test, Constant scores, and UCLA Shoulder Score, while subscapularis function was evaluated with passive and active rotation measurements, belly-press, and lift-off tests. Postoperative follow-up occurred at 3, 6, and 12 months. Results: The mean age of patients in the arthroscopic and open surgery groups was 45.33 and 45.93 years, respectively. Postoperative Constant scores improved significantly in both groups (arthroscopic: 87.06±7.8, open: 84.06±2.84, p=0.001). The arthroscopic group demonstrated better improvement in the lift-off test (14 patients with negative outcomes) compared to the open surgery group (8 patients, p=0.018). Forward elevation significantly improved in the arthroscopic group (175.66±10.49°) compared to the open surgery group (162.66±7.76°, p < 0.001). Conclusion: Arthroscopic repair of subscapularis tears results in comparable functional outcomes to open surgery, with superior improvements in specific functional measures like lift-off test and forward elevation. These findings suggest arthroscopic repair as a favorable option in selected patients.