Injury to the distal triceps brachii tendon is uncommon and usually the result of a fall onto an outstretched hand. Most reports associate such rupture with the use of anabolic steroids, weight lifting, and laceration. Other local and systemic risk factors for injury to the distal triceps tendon include local injection of steroids, bursitis of the olecranon process, and hyperparathyroidism. Also implicated in injury, particularly in professional athletes, is eccentric loading of a contracting triceps muscle. The initial diagnosis may be difficult to make because a palpable defect in the tendon is not always present. Pain and swelling may further limit the ability to evaluate the strength and range of motion of the affected elbow. Although plain radiographs help to rule out other pathology, MRI confirms the diagnosis and may guide management. Treatment for incomplete tears of the distal triceps tendon, with active extension against resistance, is nonsurgical. Surgical repair is indicated in active individuals with complete or incomplete tears of the tendon and loss of strength. Such repair is reported to provide good to excellent results, and even the surgical repair of chronic tears can yield very good results.