This retrospective study sought to determine the effectiveness of the acellular human dermal allograft as a bridging device for reconstruction of massive irreparable rotator cuff tears (RCTs). Fourteen patients with an average age of 54.6 years underwent open reconstruction for massive irreparable RCTs. Significant improvement was found for pain and range of motion (ROM). Patient satisfaction was high. The mean American Shoulder and Elbow Surgeons (ASES) score improved from 23.8 points preoperatively to 72.3 postoperatively (P = .001). A significant correlation was found between the size of the tendon gap, which was bridged with the allograft, and the pain, ROM and ASES score. Patients with less than 2 cm tendon gap had a better outcome than those with greater tendon defects. Open reconstruction of chronic massive irreparable RCTs with human dermal allograft interposition is an alternative technique with encouraging short-term results. Our study indicates that the dermal allograft can be used safely to bridge tendon gaps of up to 2 cm with great success.