Introduction: The posterior tarsal tunnel syndrome (PTTS) is conceptualized as a compressive neuropathy of the tibial nerve (TN) or its branches within the tarsal tunnel. Objectives: To describe the concept, anatomy, pathophysiology, symptoms, signs, propaedeutics, conservative/surgical/minimally invasive treatment, surgical complications, and prognosis. Discussion: The most common symptoms of PTTS are paresthesia, pain, dysesthesia, and allodynia. Among the most cited causes in the literature are those of traumatic, infectious, inflammatory, tumoral, vascular, and idiopathic origin. Can be included in the differential diagnosis group for PTTS: diabetic polyneuropathy, lumbar radiculopathy, deep flexor compartment syndrome, Morton’s neuroma, calcaneal spur, inflammatory changes in the plantar fascia and ankle ligaments. Conservative treatment consists of correcting the underlying conditions that somehow contribute to the clinical picture, such as inflammatory processes, corticosteroid infiltrations, insoles, and the use of ultrasound-guided pulsed radiofrequency. As a surgical modality, open and endoscopic decompression of the tarsal tunnel is described. Conclusion: PTTS is a rare compressive syndrome of the lower limb that can cause pain in the plantar region. It presents numerous underlying causes that require further investigation for confirmation. The initial management of these patients should be conservative, with surgery indicated only in refractory cases.