The Achilles tendon is the most commonly ruptured tendon of the human body after rotator cuff and quadriceps tears. There is no standard option in the treatment of its ruptures. The treatment is planned based on shared decision making between the surgeon and the patient. The increased application of minimal invasive methods in surgical repair has introduced several techniques in the endoscopic approach of Achilles tendon repair. Use of an endoscopic technique may better visualize the ruptured area and thereby repair the tendon by maintaining the physiologic tension, and provide more acceptable cosmetic results, and decrease the time to return to activity after surgery. In this chapter, the existing literature about endoscopic approach in Achilles tendon surgery is highlighted along with the relevant clinical experience of the authors.