#### Summary points Disorders of the Achilles tendon are common in active people—competitive and recreational athletes alike—but they can occur in less active people. As the largest tendon in the body, the Achilles experiences repetitive strain from running, jumping, and sudden acceleration or deceleration, so is susceptible to rupture and degenerative changes. This review aims to describe the anatomy and diagnostic evaluation of the Achilles tendon, and to discuss the best available evidence to help in the management of Achilles tendon disorders. #### Sources and selection criteria We searched Medline (to include the Cochrane database) with the terms tendinopathy, Achilles tendon, tendon injuries, and Achilles tendon disorders. This was further limited to Achilles and finally to English language, human subjects within the past five years, and randomized controlled trials or evidence based reviews. The search yielded 70 references. We reviewed the abstracts of these 70 references and 57 met the inclusion criteria. Further landmark studies were added. The Achilles tendon is the strongest tendon in the body,1 serving both the gastrocnemius and soleus muscles. It begins near the mid-calf and inserts posteriorly at the calcaneus (fig 1⇓). In the region where the tendon joins the bone, there is an amalgam called the enthesis organ, in which the tissue is a composite of bone and tendon.2 Kager’s fat pad is located anterior to the Achilles tendon and posterior to the calcaneus, forms the superior border of this enthesis …