Objective To evaluate the clinical effect of hemitendinosus muscle reconstruction and anchor insertion repair in the treatment of old patellar tendon rupture. Methods Eight patients with old patellar tendon rupture were repaired with anchor and tendon reconstruction with hemitendinosus muscle to strengthen the patellar tendon. After the operation, the knee was fixed in a straight position with adjustable brace for 2 weeks. The range of knee was gradually exercised. IKDC and Lysholm scores were used to evaluate the knee joint function before and after operation in the follow-up patients. Clinical evaluation includs circumference of thigh, range of motion of knee joint and patella height were measured and compared with contralateral. Results No complications such as rupture of patellar tendon and wound infection were found after reconstruction of patellar tendon in all patients. 8 patients were followed up, with an average follow-up of 43.2 months, according to the Lysholm scale, preoperative for ( 46. 12 ±2. 29), at the last follow-up ( 81. 35 ± 3. 40，P＜0. 05) , IKDC scores for preoperative（45.5± 10.8), the last follow-up（65.8 ± 9.42，P＜0. 05), all patients have different degree of quadriceps atrophy, The difference in circumference between the injured side and the healthy side was 2.6± 0.7cm. At the last follow-up, knee mobility and patella height were measured by X ray, and the difference was not statistically significant when compared with the opposite side (P > 0. 05). Conclusion The treatment of old patellar tendon rupture with hemitendinosus muscle reconstruction combined with anchor repair is reliable and worthy of clinical promotion.