Objectives The aim of this study was to evaluate the healing process of a torn Achilles tendon after surgical repair using ultrasound elastography. Methods This study was set in a prospective case-control analytic design. Patients who underwent surgical repair of complete rupture of the Achilles tendon were enrolled, together with a control group. The data for the patient group were assessed at 12, 24, and 48 weeks postoperatively. All patients were evaluated by the American Orthopedic Foot and Ankle Scale. Values for the thickness, the cross-sectional area, strain elastography, and shear wave elastography (SWE) were compared on a high-resolution doppler ultrasound system. Results The percentage of the red-to-yellow code was the highest (57.7%) at the 12th-week evaluation, and the percentage of the green code was the highest at the 24th-week (53.8%) and 48th-week (69.2%) evaluations. With respect to color codes on the nonruptured side, the percentage of green increased and the percentage of blue decreased over time (P = .002). The SWE values increased over time on the ruptured side and decreased on the nonruptured side. There was a positive correlation (moderate) between the American Orthopedic Foot and Ankle Scale and SWE values at the 24th- and 48th-week evaluations. Conclusions The results of this study demonstrated that the Achilles tendon seems to become stiffer with the healing process. Ultrasound elastography can provide structural information about the healing process of the Achilles tendon after surgical repair and can quantify findings for follow-up.