Closed rupture of the tibialis anterior tendon is a relatively uncommon clinical phenomenon, and review of the literature reveals fewer than 150 reported cases. Even more limited are the reported treatment methods and repair techniques. The disruption of the tendon can occur as a result of traumatic or atraumatic rupture, and is often a missed diagnosis that presents late to the treating surgeon. Depending on the time since injury and condition of the tendon, the rupture may be repaired either primarily or through secondary repair with autogenous interpositional grafting. Regardless of age, sex, medical comorbidities, and diagnostic delay, both techniques have shown promising results. The repair of the ruptured tibialis anterior results in restoration of dorsiflexion strength, ankle cosmesis, and return of function. Depending on the patient’s functional deficit and desired level of activity, surgical repair is generally a safe and effective means to restore function, independent of injury acuity.