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Complete ruptures of the proximal hamstring tendon insertion are less common than typical muscle tendon junction strain injuries, with a far more debilitating natural history. The present study was designed to assess the subjective and functional outcomes of a group of patients following surgical repair of both acute and chronic complete proximal hamstring tendon ruptures.Twenty-five patients with an average age of 44 years comprised the study cohort. Clinical and diagnostic tests confirmed the diagnosis. All patients underwent primary repair of the tendon to the ischium with suture anchors and were protected postoperatively for 4 to 6 weeks. Following a progressively phased strengthening and functional exercise program, strength was isokinetically assessed. The Proximal Hamstring Injury Questionnaire was completed by all patients.All patients reported being satisfied with their outcomes following surgical repair. Strength scores for patients who were 6 months to <12 months (N=1 0) postoperative averaged an 87% (range, 69%-108%) strength return. Patients who were ≥ 12 months postoperative (N=15) averaged a 98% strength return (range, 72%-176%).Patients sustaining a severe injury to the hamstring muscle caused by an external load should be suspected of having a proximal hamstring tendon disruption. Magnetic resonance imaging examination is necessary to confirm the diagnosis and assess the pathologic anatomy. Surgical repair of both acute and chronic cases yielded good results with a high degree of patient satisfaction and objective functional recovery.