Injuries to the distal biceps tendon occur rather infrequently and the usual mechanism of injury is forced extension of the elbow. Rupture of the distal biceps tendon is usually accompanied by a popping sensation and results in loss of supination and flexion strength along with retraction of the biceps muscle. Surgical treatment of this injury is strongly recommended for patients who want to avoid losing significant supination, flexion, and grip strength. The traditional method of repair is reattachment of the tendon to the anatomical footprint on the radial tuberosity. This article examines the different treatment strategies and their clinical outcomes for distal biceps tendon ruptures.