Category: Sports Introduction/Purpose: While there is no current consensus on whether to use an open or minimally invasive (MIS) approach for Achilles tendon repair after acute rupture, there is a recent trend towards decreasing complication rates for both procedures as well as favorable clinical outcomes. While many studies have compared complication rates between these procedures, no study has examined differences in clinical outcomes using PROMIS scores with a large cohort of patients. PROMIS has been validated for use in assessing outcomes following Achilles repair and allows for evaluation of surgical outcomes compared to population means. We hypothesized that patients in both open and MIS groups would have improved PROMIS scores postoperatively, but that there would be minimal differences in PROMIS scores and complication rates between surgical techniques. Methods: 228 patients were identified who underwent surgery for acute unilateral Achilles tendon repair between January 2016 and December 2018. Nine surgeons were represented. The open repair group was defined by a larger incision (>4 cm) and no use of a commercially available minimally invasive device. The minimally invasive group was defined by a smaller incision (