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Abstract Purpose To compare the clinical and functional outcomes of arthroscopic rotator cuff repair over a period of 2 years using three postoperative rehabilitation modalities: aquatic therapy, land‐based therapy, and self‐rehabilitation therapy. The null hypothesis was that aquatic therapy would provide no difference in Constant score compared to land‐based therapy and self‐rehabilitation therapy. Methods A prospective study was performed on subjects scheduled for arthroscopic rotator cuff repair between 2012 and 2017 that complied with the following criteria: (i) small to medium sized symptomatic supraspinatus and/or infraspinatus tendon tears, (ii) low to moderate tendon retraction according to Patte, and (iii) fatty infiltration stage ≤2. Patients were allocated to perform either aquatic therapy, land‐based therapy, or self‐rehabilitation therapy for 2‐4 months. Independent observers blinded to the study design collected Constant score, SSV, and patient satisfaction at 2 months, 3 months, 6 months, 1 year and 2 years. Study design Level III, cohort study Results At 2 months follow‐up, patients performing aquatic therapy had significantly higher Constant scores (p