Improvements in arthroscopic repair of rotator cuff (RC) tears and suture anchor technology have concurred to the development of stronger constructs with multiple suture configurations, allowing repair of large and massive tears through minimally invasive means. However, although repair instrumentation and techniques have improved, healing rates have not. In fact, there is a high incidence of failure ranging from 30% to 94%. Arthroscopic repair of massive RC tears is associated with less favorable clinical results and the highest retear rate when compared with the repair of smaller tears with structural failure in up to 90% at 1 and 2 years postoperatively. In order to reduce the failure rate after surgery, several experimental in vitro and in vivo biologically based strategies to augment RC repair were developed. Purpose of this chapter is to provide an extended review of all possible factors (like platelet-rich plasmas [PRPs], stem cells) and techniques (Augmentation or bridging patches, Patches in superior capsular reconstruction) that could improve our anatomical results after rotator cuff repair.