Abstract: [Objective] To clarify the clinical effect of ultrasound-assisted minimally invasive repair of acute Achilles tendon rupture.[Methods] A total of 66 patients (66 foot) needed surgical treatment for acute Achilles tendon rupture from 2017 to 2020.36 patients were selected for ultrasound-assisted minimally invasive surgery (minimally invasive group)，30 patients repaired by conventional open surgery (conventional group). The results of perioperative period and follow-up were compared between the two groups. [Results] All patients completed the operation successfully. The operative time, incision length, average length of hospital stay ,intraoperative blood loss,postoperative ground weight bearing time in the minimally invasive group were significantly better than those in the conventional group. Postoperative follow-up was (12±3.45) months,the complete weight bearing time is significant early than conventional group.VAS score of the last follow-up was significantly decreased (P < 0.05), AOFAS and ARTS scores were significantly increased (P < 0.05). However, there were no significant differences in VAS score, AOFAS and ARTS score between the two groups at the last follow-up (P > 0.05). There was no significant difference in ankle range of motion between the two groups at the last follow-up (P > 0.05). [Conclusion] Intraoperative ultrasound-assisted minimally invasive repair of acute Achilles tendon rupture has the advantages of shorter operation time, less trauma, less blood loss and faster postoperative recovery