Rotator interval tears are an uncommon, but clinically important subtype of rotator cuff tear. As MRI assumes an ever increasing role in the imaging evaluation of the painful shoulder, radiologists must be aware of this entity and appreciate the difficulty in diagnosing these tears with MRI. Differentiation of a true rotator interval tear from normal synovium and capsule in this space is most likely not possible with MRI, and symptoms may be referred and misleading. It is therefore important to correlate the MR findings with the clinical history and physical examination.