The Achilles tendon is the strongest and thickest tendon in the body and plays an important role in the biomechanics of the lower extremity. It can withstand high forces during sporting exercises and excessive torsion and stretching. Achilles Tendinopathy (AT) has no pathophysiological theory and no clear understanding of the pathological process. Rest and specific exercises, NSAIDs, steroid injections and surgical treatments are currently used to treat AT. Not one of them has a dominant efficacy for any length of time. Lately, hyaluronate injections have increasingly been used for the treatment of different degenerative processes of joints and soft tissues. The authors reviewed 56 patients with insertional AT treated between 2007 and 2012. All patients were followed up for one year. Patients were divided into three groups: the first group treated by the corticosteroid injection, the second group treated by single hyaluronate injection and the third group treated by rest, splint, NSAIDs, and physiotherapy. Most patients that treated by a single hyaluronate injection showed good to excellent results for a long time in comparison with corticosteroids injections and the conservatively treated patients, according to FADI and VAS scores. In conclusion, it seems that hyaluronate injection therapy is superior to steroid therapy and non-invasive conservative treatment for insertional AT.