A large nationwide study has demonstrated the economic burden of rotator cuff injuries, as well as disparities in injury claims and management. The study assessed 351,554 claims for traumatic rotator cuff injuries in the Accident Compensation Corporation database between January 2010 and December 2018. The total cost of these injuries was more than NZ$960 million, with the greatest proportion of costs for vocational support (49.8%), then surgery (26.3%), rehabilitation (13.1%) and radiology (8.1%). Asian, Māori, and Pasifika peoples were under-represented in the proportion of total claims and had lower rates of surgery than Europeans. In addition, Māori had a higher proportion of costs spent on vocational support and lower proportions spent on radiology, rehabilitation, and surgery than Europeans. Compared with females, males had a higher number and higher cost of claims and were more likely to have surgery. Areas of high socioeconomic deprivation had the lowest number of claims compared with areas of low deprivation