Forty-nine patients with Achilles peritendinitis (APT) (11 bilateral) and 31 patients with retrocalcanear bursitis (RCB) (5 bilateral) were treated surgically (altogether 96 heels). There were 37 men and 12 women in the APT group, with a mean age of 38.4 years, and 26 men and 5 women in the RCB group, with a mean age of 32.3 years. Forty-five patients in the APT group and 30 patients in the RCB group were active in sports. All patients had been treated conservatively for at least 6 months (range 6 months to 13 years) without relief of symptoms. The operative method was bilateral longitudinal incision of fascia cruris and trimming of the adhesions to fascia and base of Kager's triangle in APT group, and ablation of the posterior upper corner of os calcaneus in RCB group. In order to assess the ability to return to sports, the healing results were evaluated by questionnaire in 42 patients (47 operations) in the APT group and 25 patients (28 operations) in the RCB group 2-11 years postoperatively. The results were excellent in 27, good in 11, fair in 7 and poor in 2 in the APT group, and excellent in 13, good in 10, fair in 2 and poor in 3 in the RCB group, respectively. Operative treatment of APT and RCB in patients whose symptoms persist after conservative treatment seems to give favourable results in the majority of cases.