Introduction: The aim of this study was to compare the results of single versus double row (TEO) in massive tears of the posterosuperior rotator cuff in patients older than 70 years old. Methods: Between October 2019 and July 2022, 46 patients, older than 70 years old, were operated on, in two centers, by one surgeon (FM), in one center, we performed a single-row repair, while in the other a double row, transosseous equivalent. Patients were paired by age and gender. All patients were studied with a preoperative MRI along with preoperative age and gender adjusted constant score. Postoperative patients were evaluated at the end of the FU. Mean time of FU for single row was 3.2 years (2–4.1) and for TOE was 3.5 years (2.4–3). Mean age for SR patients was 71.15 years (70–82) and for TOE was 74.8 years (70–81). We were able to evaluate 20 pairs of patients (15 pairs of females and five pairs of males). Results: CS differed in both groups of patients. Patients operated on with TOE had a better, but non-significant CS 81.3 (TOE) versus 75.7 (SR) p > 0.05. The patients operated own with TOE showed statistically significant better arm abduction strength than patients operated on with SR (p < 0.05). There was a trend for patients operated on with TOE to have a better ROM and less pain. Discussion: The results of our work show that patients older than 70 years old, with repairable RCT operated on with a transosseous equivalent, have a trend to have a better CS and a significantly better strength than patients operated on with SR.