Purpose of Review <p>Achilles tendon rupture (ATR) is a common athletic injury and management with operative and non-operative approaches remains a debated topic. The aim of this review is to summarize the current recommendations for prevention and management.</p> Recent Findings <p>While open surgical repair has been the gold standard for management of Achilles tendon rupture, non-surgical management has gained increasing acceptance following high-quality trials demonstrating comparable functional outcomes to surgery. Non-surgical management has a slightly higher re-rupture rate than surgical options; however, functional outcomes are comparable to surgery when combined with early mobilization.</p> Summary <p>Prevention of ATR requires a multifactorial and individualized approach; effective strategies include gradual load progression, eccentric strengthening, and early management of Achilles tendinopathy. Recent high-quality trials have shown no differences in functional outcomes between surgical and non-surgical management when combined with progressive rehabilitation protocols. Future directions emphasize individualized treatment selection, strategies for early functional rehabilitation, and advances in minimally invasive techniques.</p>