The risk of developing tendinopathy is greater amongst those who are overweight or obese. However, such data linking the two variables in elite athletes is less consistent. To this extent, the association between diet, adiposity and tendon pathology has not been investigated in this population. Consequently, recent studies have begun to investigate the effects of dietary interventions on outcomes such as tendon biomechanics and/or pain. The purpose of the following systematic review is to determine whether excessive body mass index (causing increased load and strain on tendon tissue) the underlying mechanism inducing a pathological change in human tendon cells. Or alternatively, does the systemic influences of fat predispose to tendon pathology?