Background: Traditionally Open Z-Plasty lengthening is the choice of the procedure for treating Achilles tendon contracture seen in equinus deformity of the foot, which is commonly seen in club foot, spastic cerebral palsy, polio myelitis, post traumatic and post burn contractures etc. Percutaneous Achilles tendon lengthening by triple level tenotomy technique is based on sliding of partially cut tendon preserving its biology, strength and biomechanics. This study aims to evaluate the efficacy and safety of this new surgical therapeutic method.