Introduction: In this study, percutaneous suturing for the treatment of acute Achilles tendon (AT) rupture was compared to open reconstruction for the treatment of chronic AT rupture. Materials and methods: We conducted a prospective comparison research at Department of Orthopaedics, Guntur Medical College, Guntur, Andhra Pradesh, India, between March 2021 to February 2022. Patients having a primary diagnosis of total Achilles tendon rupture were included in the analysis. Twenty-five patients were given advice on their treatment choices and encouraged to return in a year for follow-up. Results: Results of multivariate and univariate logistic regression methods are used. Comparable gram-positive and gram-negative bacterial growth was seen in this study of pleural space infections. pH, loculation, positive stain, culture, fever, and serum albumin were all statistically significant in their own right when analysed in isolation. After doing a multivariate analysis, we found that pH, loculation, and serum albumin were significant predictors of tube thoracostomy success or failure. Conclusion: Comparing open repair for chronic AT rupture to percutaneous suturing following acute AT rupture, one may find similar clinical and functional results, but a thicker tendon.