When the long head of the biceps tendon is diseased, tenodesis is an appropriate treatment strategy. The specific technique employed is dependent on visualization, fixation method and hardware, and tenodesis location. For suprapectoral tenodesis techniques, those that fix the tendon within or below the bicipital groove can be challenging due to the transverse humeral ligament covering the groove. To accurately identify the biceps tendon in this area, the ligament often requires resection. Ultrasound provides surgeons with a safe and non-invasive tool to visualize the biceps tendon as it exits the bicipital groove, negating the need for de-roofing and other pitfalls associated with traditional techniques. This Technical Note describes an ultrasound guided suprapectoral biceps tenodesis procedure.