Purpose of Review <p>This manuscript synthesizes the relevant anatomy, pathophysiology, and diagnostic workup for proximal hamstring tendon injuries. Furthermore, we review the current evidence-based management strategies for these injuries in the athlete.</p> Recent Findings <p>Non-operative management with exercise-based rehabilitation remains the cornerstone of treatment for proximal hamstring injuries. Chronic injuries recalcitrant to initial treatments may benefit from interventions such as needle fenestration, platelet-rich plasma injections, or extracorporeal shockwave therapy.</p> Summary <p>Proximal hamstring injuries are one of the most common causes of missed time from sport in athletes. They may occur acutely or after chronic biomechanical dysfunction following eccentric muscle strain. These injuries can have a prolonged recovery course and high risk of recurrence. Conservative management with activity modification and rehabilitation is appropriate for most injuries while procedural treatments are utilized for recalcitrant cases with promising efficacy. Although most injuries are treated non-operatively, surgical treatment may be required in avulsion tears or more severe myotendinous injuries.</p>