[Objective] In patients with fresh Achilles tendon rupture, a threaded anchor combined with modified Krackow suture was used to analyze its safety and effectiveness. [Methods] A retrospective analysis of 120 patients with fresh Achilles tendon rupture admitted to our hospital from May 2017 to May 2019. The simple group received simple modified Krackow suture treatment (58 cases), and the combined group received the combined modification with threaded anchor. Krackow suture therapy (62 cases). Observation indicators include perioperative conditions, follow-up indicators and imaging evaluation. [Results] The perioperative indicators of the combined group were significantly lower than those of the simple group (P<0.05). The ankle function scores of patients in the combination group were significantly better than those of the simple group (P<0.05); the incidence of adverse reactions in the combination group was significantly lower than that of the simple group (P<0.05). The excellent and good rate of imaging in the combined group was significantly better than that of the simple group (P<0.05). [Conclusion] In patients with fresh Achilles tendon rupture, the use of threaded anchors combined with modified Krackow suture therapy has satisfactory results in restoring ankle function, relieving pain symptoms and promoting Achilles tendon healing; it can also effectively avoid surgical trauma for rehabilitation Impact.