The purpose of this study was to evaluate the long-term results of surgery for chronic Achilles tendinitis. Twenty-seven competitive athletes (average age 32, range 17–56 years) and 21 noncompetitive athletes (average age 40, range 20–65 years) were studied. The average duration of preoperative symptoms was 2.7 years (range 0.25–14 years) for the competitive athletes and 4.0 years (range 0.5–27 years) for the noncompetitive athletes. In all cases, conservative treatment failed as assessed by severity of pain and extent of disability. Surgical procedures included: tenolysis (A), n = 20; tenolysis, excision of the posterior aspect of the os calcis, and the retrocalcaneal bursa (B), n = 25; and tenolysis and excision of the retrocalcaneal bursa only (C), n = 3. The average length of follow-up for all groups was 52 months (range 15–96 months). The criteria for assessment of recovery were based on the degree to which the patients were able to return to their preinjury activity level. Where there was a complete absence of pain, the result was considered excellent. Where occasional but minor symptoms persisted, the result was termed good. Using these criteria, procedure A was associated with a 95% success rate while procedures B and C (pooled because of small n) were associated with a 93% success rate. The average time for all patients to return to their preinjury level of activity was 22 ± 12 weeks following procedure A, 29 ± 16 weeks following procedure B, and 32 ± 19 weeks following procedure C. The time to “full activity” for all patients was significantly, (p< 0.05), longer following procedure B compared with procedure A. The recovery times following procedure A were significantly, (p< 0.05), longer for noncompetitive compared with competitive athletes. Ten patients did not return to their previous level of activity, four because of persistent heel pain and six due to other reasons. We conclude that surgery for chronic Achilles tendinitis is efficacious in recalcitrant cases but the choice of surgical procedure affects the time to recovery.