Currently, there are no texts focused on proximal hamstring pathology and surgical treatment options. While midsubstance muscle tears of the hamstring are typically treated non-operatively, proximal hamstring tears often require surgery, which can create anxiety for the orthopedic surgeon, as the exposure is deep and the sciatic nerve is at risk for injury. Moreover, the algorithm for repairing proximal hamstring tears is complex, as the spectrum of pathology starts from partial tears to acute tears to chronic tears with varying degrees of retraction. With the advent of arthroscopic procedures around the hip, innovative treatment methods such as endoscopic surgery have been utilized to repair the proximal hamstring. For successful treatment of chronic hamstring tendon tears, allograft reconstruction has been shown to be successful.