Achilles tendon ruptures are rising across all ages, driven by increased sports participation, single-sport specialization in youth, evolving basketball mechanics that demand higher volumes of explosive push-off movements, and footwear trends that heighten tendon stress. Degeneration appears present in most ruptures, even among teenagers. Preventive strategies remain limited, though strength, flexibility, and workload management may help. While many patients can be treated non-operatively, shared decision-making remains essential, particularly for athletes weighing recovery timelines, re-rupture risk, and return-to-sport expectations.