We describe an arthroscopic technique for irreparable rotator cuff tears using patch bridging reconstruction with fascia lata autograft. Compared with conventional rotator cuff repair, this technique reconstitutes the rotator cuff as a dynamic structure, preserves the rotator cuff remnant, reduces excessive tension of the rotator cuff, and preserves the shoulder joint. The fascia lata patch itself is low cost and avoids risks of transmission of blood-borne infectious diseases and rejection. Although the bridging reconstruction is a complex operation with a long learning curve, we believe patch bridging using fascia lata is a highly effective and reproducible surgical protocol for appropriate irreparable rotator cuff tear patients.