Thirty-one patients with chronic insertional Achilles tendinopathy were randomized to receive low-energy extracorporeal shockwave therapy (ESWT) (n=16) or sham therapy (n=15). The primary outcome of interest was pain on a Visual Analogue Scale (VAS). The secondary outcome of interest was the VAS foot and ankle (VAS-FA) total score and pain, function and other complaints sub-scores. Additionally, the incidence of complications and rescue analgesic use. All outcomes were measured at 2, 3, 4, 6, 12, and 24 weeks post-treatment. The results revealed that VAS pain was statistically significantly improved from baseline at 4 to 12 weeks in the EWST group, and at 12 and 24-weeks in the Sham group (p<0.05 for all). Furthermore, VAS-FA pain sub-scores in the sham group were statistically significantly improved from baseline at both 12 and 24 weeks (p<0.05 for both). However, all other outcomes did not improve from baseline in either the EWST or control groups. Across all timepoints, no statistically significant difference was observed between the EWST and sham groups for all outcomes (p>0.05 for all).