Tactical athletes are individuals in service occupations with significant physical fitness and performance requirements such as law enforcement, firefighters, emergency responders, and military service members. Tactical athletes also may have specific administrative requirements related to documenting physical injuries. Musculoskeletal injuries are a large burden on the tactical athlete population, with incident rates varying based on the specific profession. Chronic exertional compartment syndrome (CECS) is difficult to manage in the tactical athlete population due to their limited ability to reduce impact activities and poor surgical outcomes. Botulinum neurotoxin-A and gait retraining show promise as alternative treatments for CECS. Heat injuries are frequent in the tactical athlete populations, and a graduated return to play process helps to prevent morbidity. Management of musculoskeletal injuries in tactical athletes requires consideration of operational schedules and adequate reconditioning, in addition to traditional injury evaluation.