Initial management of LHB tenosynovitis consists of nonoperative treatment that includes nonsteroidal anti-inflammatory drugs, physiotherapy, and corticosteroid injections. Surgery can be considered in cases that have nearby glenohumeral structures. Failed a trial of conservative treatment with persistent shoulder pain and dysfunction. Intraoperatively, tenosynovitis of the LHB presents with vascular injection and reddening of the tendon and sheath, thickening of the tendon, and edema between the LHB tendon and sheath. The 2 recommended surgical treatment options are biceps tenotomy and tenodesis. While there is no consensus on which LHB surgical technique is superior, several studies have shown that LHB tenodesis, in contrast to tenotomy, has a lower complication rate, better shoulder function, and less postoperative cramp- ing pain and deformity, with better cosmesis. Subsequently, tenodesis seems to be the more appropriate intervention for an active population with biceps pathology. Biceps tenodesis (BT) can be performed in either a suprapectoral or subpectoral technique based mainly on surgeon preference.