Objectives: SLAP tears are a common occurrence in baseball pitchers. There is not a clear consensus on the treatment of these injures in the overhead athlete, especially in the setting of a failed SLAP repair. SLAP repair in overhead athletes has had relatively poor results with return to play outcomes in several reports. Biceps tenodesis has become an option for failed SLAP repair or chronic biceps tendinitis in older patients with excellent results, but little has been reported concerning biceps tenodesis in overhead athletes. The purpose of this study was to evaluate the outcomes and function of elite level baseball pitchers after undergoing biceps tenodesis. Methods: Retrospective review was performed of 13 baseball pitchers with primary or repeat SLAP tears or biceps tendinitis who were treated with biceps tenodesis. Results: Twelve of thirteen (92%) players were contacted who underwent biceps tenodesis at mean follow-up of 3.4 years (range 1-12.3 years). Outcome measures included the ASMI labral repair outcomes questionnaire, ASES scoring system, overhead athlete shoulder and elbow score, KJOC, and the veterans rand 12 item health survey (VR-12). Eleven of 12 (92 %) contacted were able to return to playing with the most common complaint being subjective weakness and a decrease in velocity. Patients had an average score on the VR12 physical of 63, VR12 mental of 42, KJOC 79, and ASES 97. Conclusion: Biceps tenodesis in an overhead throwing athlete is an acceptable option for a failed slap repair or biceps tendonitis that fails to respond to conservative treatment. Throwing athletes should expect to get back to baseball with good outcomes, however some pain or discomfort with maximum velocity is common.