<p>Hamstring injuries are among the most frequent sports injuries, ranging from strains to complete tears and proximal avulsions. Typical mechanisms include eccentric overload in terminal swing (sprinting type) and forced hip flexion with an extended knee (stretching type). Clinical manifestations are sudden posterior thigh pain, bruising, loss of strength and flexibility and with proximal avulsions pain when sitting. Neurological symptoms suggest sciatic nerve involvement. Magnetic resonance imaging (MRI) is the diagnostic gold standard (localization, extent, number of tendons, retraction, chronicity) and forms the foundation of the interpretation of indications; X‑radiographs help exclude apophyseal/bony avulsions and sonography supports the dynamic assessment. Classification systems (Peetrons, BAMIC, Wood) standardize reporting but have limited prognostic value. Conservative treatment is appropriate for insertional tendinopathy, myotendinous lesions, single-tendon tears and two-tendon tears with &lt; 2 cm retraction or low functional demands. The main element is a phased rehabilitation with criteria-based eccentric strengthening and lumbopelvic control; platelet-rich plasma (PRP) can be considered case-by-case in chronic, treatment-resistant symptoms. Surgery is usually indicated for ≥ 2 tendons involved, complete avulsion, ≥ 2 cm retraction, early neurological signs or high performance demands. Endoscopic repair is suitable for acute, minimally retracted tears, open procedures are preferred for retraction or chronicity and larger defects require reconstruction strategies. Muscle belly lesions generally heal nonoperatively. Distally, biceps femoris ruptures often benefit from early refixation, while semitendinosus/semimembranosus lesions can initially be conservatively treated. Overall, the results after adequate interpretation of the indications are good. There is a need for research on criteria for surgery, prognosis models (return to sports, recurrence) and standardized outcomes.</p>