Background Patella tendon ruptures are relatively rare soft-tissue musculoskeletal injuries. The incidence of patella tendon ruptures has been reported to be 0.689 in 100,000. Repair of patella tendon ruptures is necessary to restore the knee’s extensor mechanism and provide the patient with a functional gait. Multiple techniques have been published for the repair of a patella tendon rupture. When indicated, including a V-Y quadricepsplasty in the procedure allows for a tension-free repair by lengthening the quadriceps tendon. Purpose This video overview and case presentation demonstrates the use of transosseous tunnels to repair the medial half of the patella tendon to the patella, a suture anchor to repair the lateral half of the patella tendon to the tibial tubercle, and a V-Y quadricepsplasty to lengthen the quadriceps tendon. Methods The anatomy, examination, diagnosis, and treatment options for a patella tendon rupture are reviewed. We discuss surgical indications and considerations, including an inability to perform a straight leg raise and demonstration of patella alta on radiographs. The case of a 79-year-old man with an acute patella tendon rupture is presented. After a thorough discussion of risks, benefits, and prognosis with our team, the patient elected to proceed with a patella tendon repair with V-Y quadricepsplasty. Results Successful repair of the acute patella tendon rupture was completed intraoperatively. Postoperative clinical outcome showed good motion of the knee at the 6-month follow-up visit. Conclusion Primary patella tendon repair offers a reliable restoration of function after an acute patella tendon rupture. An intraoperative V-Y quadricepsplasty may be necessary to establish a tension-free repair in patients with a preoperative knee flexion contracture. A postoperative plan with supervised physical therapy is crucial to obtaining good functional outcomes.