Subacromial impingement syndrome (SAIS), often used interchangeably with “shoulder pain,” constitutes a wide range of rotator cuff pathologies, posing diagnostic complexities. Notably, it ranks as one of the primary contributors to shoulder pain, even without a complete rotator cuff tear. The ongoing debate revolves around surgical procedures, such as acromioplasty and arthroscopic subacromial decompression. Currently, consensus recommends reserving these surgical options after a 6-month trial of conservative management, encompassing physiotherapy and corticosteroid injections. To advance our comprehension and optimize treatment approaches for this multifaceted condition, it is imperative to conduct further long-term studies with a specific focus on the acromion and rotator cuff tendon pathology.