Distal biceps tendon rupture is a rare injury which results in loss of flexion and supination strength. Disruption invariably occurs at the radial tuberosity. Early direct reattachment with a modified two incision Boyd-Anderson type repair is depicted in the following series. Under tourniquet, the tendon is exposed through a volar "S" incision at the elbow. The hematoma is evacuated and the tendon is identified.