Peroneal tendon pathology is an undervalued source of lateral foot and ankle pain in athletes and can be difficult to distinguish from other lateral ankle injuries. There are three broad categories of peroneal tendon pathology:​ peroneal tendinitis/tendinopathy, peroneal tendon tears, and peroneal subluxation/dislocation. An understanding of the anatomy and biomechanics of the peroneal tendons is essential for diagnosis and proper treatment of its pathology. Space-occupying conditions such as low-lying muscle belly of the peroneus brevis or peroneus quartus, ankle instability, hindfoot varus, or pes cavovarus must be ruled out in all the cases. Proper conservative treatment is effective in athletes with tendinopathy. On the other hand, gross symptomatic ruptures or subluxation/dislocations should be surgically treated in order to return to their professional activity level.