Background There are many different techniques for repair of chronic quadriceps ruptures. Allograft reconstruction with Achilles tendon is relatively straightforward, and the key is to incorporate as much of the old tendon as possible. Methods The anatomy, examination, diagnosis, and surgical approach options are reviewed. One and a half years after a fall, a 47-year-old man experienced a missed quadriceps tendon rupture injury. After a thorough discussion of risks, benefits, and prognosis was presented to the patient, he elected to proceed with surgical fixation for restoration of function. Results At 6 months after surgery, the patient had full and painless knee range of motion, 5/5 quadriceps strength, 0&[deg] extensor lag, and a normal gait pattern. Conclusion Chronic quadriceps ruptures are a challenging injury to treat, but success can be achieved with the Achilles tendon allograft reconstruction method described in this video.