Tendinopathies are challenging and are common in athletes and in middle-aged overweight patients, the latter generally with no history of increased physical activity. “Tendinopathy” refers to a clinical condition characterized by pain, swelling, and functional limitations of the tendon and nearby structures and seems to be the effect of a chronic failure of the healing response process. Tendinopathies can produce marked morbidity, and, at present, scientifically validated management modalities are limited. Achilles and patellar tendons are the most vulnerable tendons, and those most frequently involved in overuse injuries. Achilles and patellar tendinopathies can be treated conservatively primarily, obtaining acceptable results and clinical outcomes. When this approach fails, surgery should be considered. Several surgical procedures have been described for both conditions with a relatively high rate of success with few complications.