Sixty-eight patients' charts were reviewed for ascertainment of the complication rate following operative repair of ruptured Achilles tendons. Ninety-two percent of 48 patients whose cases underwent clinical evaluation returned to their preinjury activity status: 13% had incisional complications, most of which resolved. The rerupture rate was 3% (2/68). The results of this series and a literature review show that operative treatment can be regarded as an acceptable method. Nonoperative treatment should be considered in a nonathletic patient over the age of 50 years because of potentially serious problems with wound healing.