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Injuries to the tibialis anterior tendon (TAT) are rarely reported in the literature, and, in existing reports, there are varied treatment options. Many authors recommend operative treatment over conservative treatment in young, healthy, and active patients, in order to give the patient as much strength back as possible and to allow them to avoid the use of a brace. Different types of operative repair have been described, including: extensor digitorum longus transfer, extensor hallucis longus transfer, plantaris transfer, Achilles autograft, as well as gracilis and semitendinosus autografts and allografts. We advocate using a hamstring autograft, either gracilis in isolation, semitendinosus in isolation, or a combination of the 2, depending on the size of the patient’s tendons, to operatively reconstruct ruptured TATs.Level of Evidence: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.