Tennis elbow tendinosis (epicondylitis) is most commonly caused by tendon overuse and failed tendon healing. The pathoanatomy of overuse tendinopathy is noninflammatory "angiofibroblastic tendinosis." The specific areas of elbow abnormality include the extensor carpi radialis brevis-extensor digitorum communis complex laterally, the pronator teres, flexor carpi radialis medially, and triceps posteriorly. The primary goal of nonsurgical treatment is to revitalize the unhealthy tissue that produces pain. Successful nonsurgical treatment comprises rehabilitative resistance exercise and progression of the exercise program. If rehabilitation fails, surgical treatment can be quite successful.