Reverse total shoulder arthroplasty (RTSA) decreases pain and improves function in patients with rotator cuff tear arthropathy. Grammont-style RTSA medializes and distalizes the glenohumeral center of rotation, allowing the deltoid to substitute for a deficient rotator cuff. This surgical technique video illustrates an RTSA procedure in a 72-year-old-man with rotator cuff tear arthropathy and clinical manifestation of shoulder pain with poor active forward elevation. Radiographs confirm the diagnosis of cuff arthropathy. The video demonstrates a deltopectoral approach to gain access to the glenohumeral joint. Glenoid exposure is emphasized, and glenoid component positioning shows how a slight inferior tilt and inferior placement of the baseplate can be achieved to maximize fixation and avoid scapular notching. The video shows how humeral stem is inserted and how its version can be matched to that of the glenosphere. Intraoperative tensioning methods are also demonstrated. Results from the literature have been favorable, and suggest that RTSA is a viable procedure for the treatment of disabling rotator cuff arthropathy. The principles demonstrated in this surgical video should enhance the reliability of outcomes after RTSA.