Tendons around the ankle and foot play a crucial role in weightbearing, balance control, and dynamic movement. Due to their course through narrow fibro-osseous tunnels and constant exposure to repetitive mechanical stress, these tendons are particularly vulnerable to overuse, trauma, biomechanical malalignment, degenerative changes, and systemic conditions. The etiopathogenesis of tendon disorders is multifactorial, involving collagen disorganization, hypovascular zones, microtrauma accumulation, mechanical impingement, and inflammatory pathways. This review summarizes the current understanding of the etiopathogenesis of tendon pathologies of the ankle and foot.