Objective To investigate the application effect of arthroscopic double lock loop suture technique in patients with small- to medium-sized rotator cuff tears.Methods From January 2022 to January 2024, a total of 94 patients diagnosed with small- to medium-sized rotator cuff tears at the Changzhou Affiliated Hospital of Nanjing University of Chinese Medicine were enrolled. Using a random number table method, these patients were randomly assigned into a control group and an observation group, with 47 cases in each group. The control group received conventional single-row modified Mason-Allen technique, while the observation group received arthroscopic double lock loop suture technique. The perioperative indicators (operation time, intraoperative blood loss, number of anchors used, hospital stay) were recorded in both groups. The range of motion of the shoulder joint was compared between the two groups before surgery and 6 months after surgery. Shoulder joint function was evaluated before surgery and 6 months after surgery using the ASES score, the UCLA shoulder rating scale, and the Constant-Murley shoulder score. All patients were followed up for 12 months to record the incidence of joint stiffness and recurrence rate.Results No statistically significant differences were observed in intraoperative blood loss or hospital stay between the control group and the observation group (both P > 0.05). The operation time was significantly shorter and the number of anchors used was significantly lower in the observation group than in the control group (both P < 0.05). For shoulder range of motion, postoperative abduction, forward flexion, extension, and external rotation were significantly greater in the observation group than in the control group (all P < 0.05). Within each group, all postoperative range-of-motion parameters were significantly improved compared with preoperative values (all P < 0.05). Similarly, postoperative ASES score, UCLA shoulder rating scale score, and Constant–Murley score were significantly higher in the observation group than in the control group (all P < 0.05). Within each group, all postoperative functional scores were significantly improved relative to preoperative levels (all P < 0.05). The incidence of joint stiffness and recurrence rate were significantly lower in the observation group than in the control group (both P < 0.05).Conclusion Arthroscopic double lock loop suture technique can shorten operation time, reduce the number of anchors used, and decrease the risk of postoperative joint stiffness and recurrence in patients with small- to medium-sized rotator cuff tears.