Background Proximal hamstring injuries commonly occur among athletes and nonathletes alike, typically resulting from an eccentric muscle contraction and most frequently occurring at the musculotendinous junction. Tears can be partial or full-thickness intrasubstance tears or avulsions off the ischial tuberosity. These injuries are debilitating and negatively affect athletic performance and quality of life. Purpose This video overview and case presentation demonstrates endoscopic techniques for the repair of proximal hamstring tears. Methods The anatomy and examination, diagnosis, and treatment options for proximal hamstring tears are reviewed. We discuss surgical indications and considerations including sciatic nerve identification and neurolysis, tendon débridement, and suture anchor fixation. A case of a 49-year-old woman with bilateral proximal hamstring tears is presented. After a thorough discussion of risks, benefits, and prognosis, the patient elected to proceed with staged endoscopic repair of her proximal hamstring tears. Results Suture anchor fixation of the proximal hamstring tear with appropriate tension was obtained intraoperatively. The sciatic nerve was visualized and adhesions were débrided. Postoperative clinical outcome showed excellent restoration of motion, strength in hip extension and knee flexion, and pain relief. Conclusion Endoscopic repair of proximal hamstring tears offer reliable restoration of function. Appropriate indications and identification of tear extent, suture fixation, and tensioning are crucial to good functional outcome.