Long biceps tendinopathy is a common condition resulting from subacromial impingement leading to rotator cuff tears. Conservative treatment like rehabilitation and infiltrating are available (Dufour and Del Valle, Anatomie clinique des membres. Maloine; 2017), but when these fail, surgery becomes necessary. Tenotomy is usually performed arthroscopically in the operating room under general or regional anesthesia with sedation. Ultrasound-guided surgery can manage chronic tendinopathies through tenotomy without arthroscopy and under local anesthesia, in the context of office-based surgery, and it’s indicated in patients with anesthesia-related vulnerabilities who cannot undergo shoulder arthroplasty surgery or present with a massive irreparable rotator cuff tear.