This video demonstrates the complete surgical technique for an open harvest of the lower trapezius muscle and tendon transfer in the shoulder. The lower trapezius tendon transfer is a reliable surgical option to restore shoulder motion, strength, and function. It is predominantly performed for massive irreparable rotator cuff tears, tetraplegia, post-traumatic reconstruction, and brachial plexus injuries in children and adult. Portions of the procedure are performed arthroscopically, but the harvest and mobilization of the lower trapezius is performed open. The open harvest has seven critical steps: surgical landmarks, excision of subcutaneous fat, identify the inferior oblique edge of the trapezius, release the lower trapezius from the scapular spine, mobilize the lower trapezius, separate the lower trapezius from the middle trapezius, and Krakow sutures for reinforcement.