Calcaneus fractures, the most common tarsal fractures, present significant challenges due to their complex anatomy and high-energy mechanisms. Historically, advancements from Böhler’s foundational work on open reduction to modern minimally invasive techniques have transformed management. Key classification systems, such as Essex-Lopresti (tongue-type vs. joint depression) and Sanders CT-based classification (Types I–IV), guide treatment decisions by correlating fracture patterns with prognosis. Displaced intra-articular fractures (Sanders II–IV) typically require surgical intervention, while non-operative management is reserved for non-displaced fractures or high-risk patients. Surgical approaches like the extensile lateral approach (ELA) offer anatomical reduction but carry risks of wound complications, whereas minimally invasive techniques, including the sinus tarsi approach (STA), reduce soft tissue damage and infection rates. Emerging technologies, such as 3D printing, computer-assisted surgery, and biodegradable implants, enhance precision and patient-specific care. Complications, including wound dehiscence, infection, post-traumatic arthritis, and malunion, remain prevalent, necessitating strategies like delayed surgery, patient optimization, and meticulous tissue handling. Rehabilitation protocols emphasize early mobilization and progressive weight-bearing to restore function. Despite advancements, challenges persist in balancing anatomical restoration with minimizing morbidity, particularly in severe fractures. Multidisciplinary collaboration and evidence-based practices are critical to optimizing outcomes, underscoring the need for personalized treatment aligned with patient-specific factors and evolving technologies.