In this prospective analysis of the sonographic findings of asymptomatic shoulders to determine the prevalence of rotator cuff lesions in black patients over the age of 40 years, we examined 106 black patients. Patients with shoulder trauma were excluded. Bilateral sonography was done on the subscapularis, supra-spinatus and infraspinatus insertions of 66 men and 50 women (mean age 52.8 years). The tears were measured and classed as partial or full thickness tears. In 33 patients, there was a history of previous trauma, but they were asymptomatic at the time of the examination. The pain score for the whole group was 1.3 on an analogue scale of 5, which means that pain is present intermittently but no medication is necessary. In 34 patients there were 42 cuff lesions. The largest (3.5 cm) was in a 73-year-old. In 17 shoulders the tear measured more than 1 cm, and in 13 shoulders the tear was partial. There was almost no weakness of subscapularis, supra-spinatus and infraspinatus muscles. We concluded that asymptomatic rotator cuff tears are as common in the black population as in the Caucasian population.