A retrospective analysis was conducted comparing open and percutaneous repair of ruptured Achilles tendon, over a 14-year period. One hundred and eight patients were identified; 70 underwent traditional open repair and 38 had a modified Ma & Griffith repair. The mean operating time with percutaneous repair was 28.5 minutes compared to 45.9 in the open group (p = < .0001). Comparable results were obtained in a subjective analysis of range of movement, stiffness, and power in both groups at time of discharge from clinic. In the open group there were four cases of rerupture (5.7%), four deep infections (4.7%), two palpable suture knots (2.9%), and one sural nerve lesion (11.4%). Complications with percutaneous repair included one rerupture (2.6%), five palpable suture knots (13.2%), four transient sural nerve lesions (10.5%), and no wound infections. There was no statistical significance between the two groups. The authors advocate percutaneous repair, in experienced hands, as a suitable alternative to traditional open techniques.