This review systematically addresses the contemporary surgical approaches to tendon transfer procedures for drop foot resulting from various etiologies, most notably peroneal nerve lesions, within the framework of pathogenesis, natural history, diagnostic and evaluation principles, conservative treatment options, surgical anatomy and biomechanical considerations, commonly employed transfer techniques, rehabilitation strategies, complications, and long-term outcomes. Drop foot is a dynamic pathology characterized by loss of ankle dorsiflexion, which, if left untreated, may progress to a tri-planar deformity involving equinus contracture, hindfoot varus/inversion, plantar flexion of the first metatarsal, and pes cavus, ultimately disrupting functional gait patterns. In clinical assessment, distinguishing between the dynamic and static components of the deformity, determining the preservation of joint range of motion, and selecting appropriate donor muscles for tendon transfer are of critical importance; therefore, gait analysis and electromyography play a pivotal role in objectively assessing the extent of muscle involvement and the potential for reinnervation. The primary goal of surgical treatment is to restore ankle dorsiflexion while simultaneously ensuring subtalar axis balance and frontal plane control, thereby establishing a plantigrade, stable, and sustainable foot function. In this context, posterior tibial tendon transfer remains the gold standard procedure for permanent drop foot, whereas alternative options, such as peroneus longus transfer, may offer valuable advantages in selected cases by reducing deforming forces in the forefoot and enhancing dynamic balance. Although modern fixation techniques and structured rehabilitation protocols facilitate early mobilization, mechanical insufficiency, adhesions, and neuromuscular adaptation challenges continue to represent key limitations affecting long-term outcomes.