Hamstring injuries are among the most common sports-related injuries, accounting for up to 39% of cases, with high recurrence rates ranging from 12% to 63%. Hamstring injuries often occur during high-speed running or stretch activities, with the long head of biceps femoris most frequently affected. Despite extensive research, prevention strategies have failed to reduce injury and recurrence rates, especially in elite sports like soccer, rugby, and athletics. Rehabilitation typically neglects the specific functional roles of individual hamstring muscles, leading to persistent deficits in strength and performance. Advances in imaging and classification systems, such as the British Athletics muscle injury classification (BAMIC), offer improved diagnostic precision, though limitations remain in correlating these findings with prognosis and treatment outcomes. Nonoperative management is the first line of treatment, except for severe injuries requiring surgical intervention, which has shown favorable outcomes in high-grade injuries and recurrent cases. Emerging trends emphasize tailored rehabilitation strategies, incorporating optimized strength training, eccentric loading, and sprint-specific adaptations to address the functional demands of the hamstrings. This chapter synthesizes current knowledge on the anatomy, injury mechanisms, risk factors, and management of hamstring injuries including surgery, highlighting the need for individualized prevention and rehabilitation to optimize recovery and minimize recurrence risk.