Triceps ruptures are relatively rare injuries. When they occur, primary surgical repair of the tendon to the proximal ulna is recommended. However, some patients require reconstruction using tendon grafting due to shortening or insufficiency of the native triceps tendon. Triceps ruptures associated with biological abnormalities (such as renal insufficiency or metabolic disease) or recurrence of rupture represent situations where a stout augmented repair is desirable. Multiple allograft and autologous tendons have been described for augmentation, but the use of gracilis and semitendinosus tendons provides superior length and size for use in triceps reconstruction. Using an illustrative case example, the evaluation of triceps insufficiency and the need for additional graft is shown. The technique of autologous hamstring augmentation for triceps insufficiency is described in detail. The importance of graded rehabilitation is emphasized with a complete program of triceps strengthening over time.