Previous studies have established the success of non-operative treatment following Achilles tendon rupture. 37/60 patients were analyzed in this follow-up study comparing an early weight-bearing protocol to standard weight-bearing protocol during dynamic rehabilitative treatment of acute Achilles tendon ruptures. The primary outcome of interest was the Achilles Tendon Rupture Score (ATRS). Secondary outcomes of interest included heel raise height and work, as well as the return to level (heavy, light but active, sedentary) of work and sporting, and the incidence of re-rupture. Follow up was performed at 4.5 years post-operation. At 4.5 years, there were no significant differences between the early weight-bearing and usual care groups in ATRS score, heel raise height or heel raise work. All 37 patients had return to some level of work by the 4.5 year follow up, and 33/37 patients had returned to some level of sporting activity. Three cases of re-rupture were observed over the course of the whole study, with no new cases after the first year.