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The Achilles tendon is the thickest and strongest tendon in the body and is responsible for providing ankle plantar flexion strength and function. Rupture of the Achilles tendon is a common but serious injury, which results in difficulties with pain, weakness, and gait imbalance with loss of ankle plantar flexion strength and function. Delay in diagnosis and treatment is the most common reason for the development of a chronic Achilles tendon rupture. Nonoperative treatment options are appropriate in patients with partial tears, without any significant functional deficits, or patients with medical comorbidities preventing them from undergoing surgical treatment. Operative treatment options include end-to-end anastomosis, V-Y lengthening, tendon transfer using the peroneus brevis, flexor hallucis longus, or flexor digitorum longus or an Achilles turndown procedure. Synthetic grafts are another viable option and can help bridge the defect.