The Achilles tendon is susceptible to various types of acute and chronic injuries as a consequence of its large size, enormous continuous functional demands during gait, and poor blood supply. Also, the occurrence of overuse syndromes of the Achilles tendon is increasing due to the modern physical life style. In this article the different forms of tendinitis (insertional and non-insertional), Haglund's deformity and bursitis are discussed. Also, acute and chronic Achilles tendon ruptures are considered, paying particular attention to non-operative vs operative treatment, where opinion is still controversial. There are many reports about the disadvantages and complications of operative treatment of closed Achilles tendon rupture, but nowadays a more aggressive approach to this entity is common.