Treatment methods for rupture and rerupture of the Achilles tendon can generally be classified under open surgical procedures, percutaneous operative and non-operative methods. There are no clear definitions of the terms percutaneous and minimally invasive repair in the literature. Logically, the two can be distinguished by visualizing the apposition of the tendon ends during the repair process. In minimally invasive repairs, the ends of the tendon can be seen joined through a small incision although the sutures themselves can be passed through stab incisions on either side of the tendon. In contrast, in a percutaneous repair, the ends of the tendons may not be directly seen, but can be visualized by ultrasound and endoscopy. Because of the wide variation in surgical techniques for the repair of a ruptured Achilles tendon, it is almost impossible to single out which method provides the best overall outcome. The open approach is the method of choice for athletes, young people and patients with chronic ruptures, because they need reconstructive surgery in order to restore function to a higher level as soon as possible, or to restore function after a certain time. Surgical techniques that have proven to be the method of choice in the case of repeated rupture of the Achilles tendon include transfer of the peroneus brevis tendon for rupture with a defect less than 6 cm and reconstruction with a free ipsilateral semitendinosus tendon graft with interference screw fixation for rupture with a defect larger than 6 cm. Also, a method of combined biological augmentation with surgical treatment is being developed.