Objective <p>We evaluate the effects of aerobic exercise combined with coenzyme Q10 (CoQ₁₀) supplementation on inflammatory markers and factors associated with post-surgical regeneration of the Achilles tendon in Wistar rats.</p> Methods <p>Twenty-five male Wistar rats were randomly divided into five groups: a sham group (SHAM: surgical procedures without tendon injury), a negative control group (NC: tendon injury without intervention), an experimental group undergoing aerobic exercise post-injury (EX), a group receiving CoQ₁₀ supplementation post-injury (CoQ₁₀), and a group receiving both aerobic exercise and CoQ₁₀ supplementation post-injury (EX + CoQ₁₀). Prior to the intervention, the rats were acclimated to treadmill running for one week. Following this, the Achilles tendons were surgically injured under anesthesia. The CoQ10 groups were administered an oral dose of 300&#xa0;mg/kg, while the exercise groups participated in treadmill running five days per week for four weeks.</p> Results <p>Histological analyses revealed that the extracellular matrix (ECM) organization in the EX + CoQ₁₀ group exhibited significantly enhanced and more orderly alignment of collagen fibers compared to the other groups. Furthermore, CoQ₁₀ supplementation demonstrated notable anti-inflammatory and antioxidant properties, contributing to the preservation of the tendon matrix by modulating the expression of matrix metalloproteinases (MMP-1, MMP-3, and MMP-9). Additionally, the EX + CoQ₁₀ group showed improved scores in the Achilles Functional Index (AFI) test and increased expression of Scleraxis.</p> Conclusion <p>The combination of aerobic exercise and CoQ₁₀ supplementation appears to be more effective for post-surgical Achilles tendon repair than either intervention alone.</p>