The advantageous character of a tendoscopic procedure as compared to open treatment has made tendoscopy an important tool in the diagnosis and treatment of posterior tibial tendinopathies. It has shown to provide clarification of diagnostic evaluation and may assist to reduce the surgical procedures. Moreover, it provides shorter rehabilitation, allows visualization of the tendons without causing damage to the surrounding tissues, and is associated with less morbidity, smaller scars, and less postoperative pain compared with open surgery. Not only does it provide a minimally invasive technique with a low complication risk, but also high satisfaction of patients. This chapter provides an overview of clinically relevant features related to tendoscopy of posterior tibial tendon pathologies, including anatomy, patient history, clinical examination, diagnostic evaluation, and treatment. Moreover, a structured step-by-step guide to posterior tibial tendoscopy is provided.