Achilles tendon disorders are common in the physically active population. Achilles tendinopathy is defined by the presence of Achilles tendon pain, swelling, and impaired performance. Achilles tendinopathies are divided into midportion and insertional types. In conjunction with clinical assessment and imaging, effective history taking is essential to diagnostic accuracy and treatment decision guidance. Commonly recommended conservative management strategies include rest and modified activity, orthotics or shoe inserts, nonsteroidal anti-inflammatory drugs, physical therapy with eccentric exercises, extracorporal shockwave therapy, and injection therapy using corticosteroids or platelet-rich plasma. Conservative management can be effective for many Achilles tendinopathy cases; it may take several weeks or even months to see significant improvement. Conservative rehabilitation protocols, as used for noninsertional disorders, may be less successful. Operative Achilles tendinopathy management should be considered when nonsurgical treatments are ineffective. Operative treatment includes open debridement of the paratenon and of the Achilles tendon proper with removal of damaged and degenerated tendon portions, or minimally invasive procedures such as percutaneous Achilles tendon release, minimally invasive stripping, and endoscopy-assisted treatment. For insertional Achilles tendinopathy, open surgery is usually required to ensure appropriate resection of the retrocalcaneal bursa and all bony prominences (Haglund spur and retrocalcaneal bone spur), intratendinous calcifications, and occasionally an enthesophyte within the tendon. If the tendon requires significant surgical release from its insertion, surgical reattachment is usually required.