Because most Achilles tendon injuries take place in sports and there has been a general increase in the popularity of sporting activities, the number and incidence of Achilles tendon overuse injuries have increased in the industrialized countries during the last few decades. The term “Achilles paratendinopathy” is used in clinical practice to describe activity-related Achilles pain combined with tenderness on palpation, providing that there is no suspicion of intratendinous pathology on the basis of patient history, clinical examination, or imaging examinations. This article discusses Achilles paratendinopathy.