The pathology of triceps tendon ruptures is a rare injury pattern, accounting for 1% of all muscle and tendon injuries, with men being affected twice as often as women. The rupture morphology is dependent on the mechanism of the accident and concomitant underlying internal and genetic diseases, which are defined as risk factors. Renal insufficiency represents the most frequently observed comorbidity and is known to cause tendopathies. The rupture location is primarily at the bone-tendon interface and only rarely at the musculotendinous junction, so that a dehiscence can be palpated at the dorsal distal humerus in the clinical examination. This can be visualized in various ways in imaging diagnostics and subsequently measured. Depending on the extent of the rupture, a decision must be made between conservative or surgical treatment. In order to ensure a satisfactory functional outcome, it is essential to establish the correct indications for conservative or surgical treatment of a distal triceps tendon rupture. Complete rupture as well as a partial lesion of 50-75% with accompanying loss of strength compared to the contralateral side necessitates a surgical intervention. For reconstruction or refixation of the triceps tendon, the V-shaped double row technique has become established as a good alternative to the classical transosseous refixation or suture bridge for a distal triceps tendon rupture.