It has been reported that the gap between the tendon stumps in chronic Achilles tendon rupture is filled with interposed scar tissue. If it was available to use the interposed scar tissue for reconstruction or augmentation of Achilles rupture, possible damage of normal tissues could be avoided. Our results show that direct repair method using interposed scar tissue for chronic Achilles tendon rupture can successfully relieve pain and restore function of the ruptured Achilles tendon in carefully selected patients.