Ruptures of the distal tendon of the biceps brachii muscle usually require surgical treat-ment to restore strong elbow flexion and forearm supination. However, the surgical procedure carries a risk of injury to neurovascular structures adjacent to the insertional tendon, and its success relies on respecting the original anatomical relations during reconstruction of the tendon. The aim of this article is to present a compendious review of relevant anatomy and practical notes which may enhance the optimal functional outcomes. Structured discussion on morphological aspects of the insertional tendon and its topography in relation to osseous and soft-tissue structures is presented. Moreover, attention is paid to technical aspects of implantation of fixation devices, so that physiological and anatomical reconstruction can be assured. This paper contains numerous schematic drawings to demonstrate the surgically relevant anatomy.

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