The current classification of extensor tendon zones has remained unchanged for several decades. In this article, a panel of international experts give their consensus and diverse views about the classification and suggest treatment guidelines for acute extensor tendon injuries for each zone. Collectively they recommend adaptation of a classification which is simpler and resembles that for flexor tendon classification. They outline specific areas of extensor tendon zones, i.e. the distal parts of the fingers, which need particular attention and specific treatment approaches. The treatment approaches of the other extensor tendon zones can generally follow the same or a similar surgical repair principle and methods, and rehabilitation protocols currently used for flexor tendon injuries. Consolidation of the classification, surgery and rehabilitation of both flexor and extensor tendons is expected to make surgical decision easier and allow wider adaptation of the clinical methods applicable to both flexors and extensors.