Abstract:[Objective] To evaluated the clinical outcomes of ultrasound-assisted minimally invasive repair of acute Achilles tendon rupture. [Methods] A total of 66 patients (66 feet) received surgical repair of acute Achilles tendon rupture from 2017 to 2020. Based on pa- tient-doctor communication, 36 patients underwent ultrasound-assisted minimally invasive surgery (MI group) , while the remaining 30 pa- tients had the tendon repaired by conventional open surgery (CO group) . The documents of perioperative period and follow-up were com- pared between the two groups. [Results] The MI group proved significantly superior to the CO group in terms of operative time, incision length, hospital stay, intraoperative blood loss and postoperative walking time (P<0.05) . Postoperative follow- up lasted for (12.34±3.45) months on a mean. The MI group resumed full weight bearing activity significant early than CO group (P<0.05) . The VAS score significantly decreased (P<0.05) , while AOFAS and ARTS scores, as well as range of motion (ROM) significantly increased in both groups over time (P< 0.05) , whereas which proved not statistically significant between the two groups at any matching time points (P>0.05) . [Conclusion] Intra- operative ultrasound-assisted minimally invasive repair of acute Achilles tendon rupture has the advantages of shortening operation time, re- ducing trauma, decreasing blood loss and improving postoperative recovery.