ABSTRACT Objective To explore the effectiveness of ultrasonographic features in the diagnosis of rotator cuff tear (RCT), and to screen the more specific signs for the diagnosis of rotator cuff tear. Methods The ultrasonographic parameters of 133 patients of RCT were analyzed by Logistic regression and diagnostic test, and to assess the diagnostic efficiency of different ultrasonographic features. Results Univariate analysis showed that intra-tendinous abnormal echo, disappearance of rotator cuff structure, tendon thinning, acromion impingement syndrome, subacromial synovial sac thickening and humeral head irregularity were significantly correlated with RCT. Finally, intra-tendinous abnormal echo was an independent risk factor for RCT (P<0.05, OR=2.85) through multivariate analysis. The intra-tendinous abnormal echo and the disappearance of rotator cuff structure are the main ultrasonographic criteria in the diagnosis of RCT. Combined with other parameters, the sensitivity and specificity can be significantly improved. Conclusion The intratendinous abnormal echo and rotator cuff defect have high sensitivity and specificity in the diagnosis of RCT, which can improve the diagnostic accuracy of rotator cuff tear by combining with other ultrasonographic features.