Treatment with Ultrasound (US) and Color Doppler (CD)-guided surgical scraping has shown good short-term clinical results in patients with chronic painful midportion Achilles tendinopathy. The objective was to prospectively follow the patients 1-year after surgery. Material: Sixty- four tendons in 47 patients (28 men and 19 women, mean age 52 (+/-12 years) on different activity levels) were in local anaestesia operated with US+CD-guided surgical scraping. In 43/64 tendons, there was also removal of the plantaris tendon. Methods: Questionnaires evaluating activity level, VAS for pain during activity, satisfaction with treatment result, and the SF-36 score (quality of life), were used before and 1-year after surgery. Results: At follow-up, the mean VAS for pain during activity had decreased from 62 (+/-20) before surgery to 15 (+/-15) after surgery (p < 0.001). All patients were satisfied with the result and had returned to full tendon loading activity. There were no complications. Both the physical and psychological parameters in the SF-36 score had improved significantly. Conclusions: For patients with chronic painful midportion Achilles tendinopathy, US+CD-guided surgical scraping, often combined with plantaris tendon removal, seems to be an efficient treatment method to recover physically and psychologically.