Rupture of the distal biceps brachii tendon is a rare but debilitating injury, resulting in significant loss of strength. Diagnosis of complete rupture is based on clinical history and physical tests, with surgical repair often recommended due to functional discomfort. Ultrasound (US) is a powerful tool for diagnosing and classifying ruptures, particularly partial ruptures, which is crucial for therapeutic decisions. A good understanding of the tendon's anatomical arrangement in two twisted bundles enables optimal analysis. If several surgical techniques are available, the minimally invasive approach to reinsert the tendon on the radial tuberosity is often preferred. Postoperative assessment includes radiographs, US, and sometimes magnetic resonance imaging, revealing postoperative changes with constant thickening of the repaired tendon. With accurate diagnosis and appropriate surgical technique, surgical repair has a low complication rate. Single-incision repairs show higher rates of re-tears and nerve injuries, and double-incision repairs are prone to heterotopic ossification.