Introduction Distal biceps ruptures usually present as an acute injury. Difficulties in treatment happen when the presentation is delayed, becoming a real challenge. Description of the issue We present a case report of a young bodybuilder who suffered a distal biceps rupture with 35 days of treatment’s delay. Treatment A surgical distal biceps reconstruction was performed. Due to prolonged chronology, a surgical repair was not possible. An acellular dermal matrix was used as a graft in order to reconstruct the retracted and frayed tendon. Intraoperative and one year follow-up clinical photos are presented showing full range of motion. Discussion Chronic distal biceps rupture is a challenging issue. A sterile acellular dermal matrix, used with a meticulous surgical technique, has shown a strong reconstruction with promising functional outcomes.