The definition of pseudoparalysis in shoulder is controversial. Gwschend initially described pseudoparalysis as an appearance of paralysis with severe rotator cuff tear. Later, Werner described pseudoparesis as active elevation under 90° caused by an irreparable massive cuff tear. Since these descriptions, many articles across the literature make the confusion between pseudoparesis and pseudoparalysis who differ in term of lesion and treatment options. Subsequently, this adds confusion to confusion when evaluating the results to determine the optimal therapeutic strategy. Conservative and arthroplasty options are discussed but the reverse arthroplasty appears to be the treatment of choice in a true pseudoparalyzed shoulder.