Objective To investigate the influence of preoperative blood lipid levels on postoperative recovery in patients with acute Achilles tendon rupture (AATR). Methods The clinical data of 353 AATR patients treated in Department of Orthopaedics Trauma of our hospital from Jan. 2021 to Jan. 2024 were retrospectively analyzed, including general clinical information and preoperative fasting blood biochemistry indices. Patients’ Achilles tendon total rupture score (ATRS) and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score were recorded 6 months postoperatively. Postoperative recovery was categorized as favorable if ATRS≥80 and poor if ATRS＜80; similarly, recovery was considered favorable if AOFAS score ≥90 and poor if AOFAS score ＜90. Univariate and multivariate logistic regression analyses were done to investigate the influencing factors of patients’ postoperative recovery. Results When categorized by ATRS, patients in the favorable postoperative recovery group exhibited significantly lower serum levels of triglyceride (TG), total cholesterol (TC), and low-density lipoprotein (LDL) compared to the poor postoperative recovery group (all P＜0.05). Similarly, when categorized by AOFAS score, the favorable postoperative recovery group had lower serum TG and TC levels than the poor postoperative recovery group (both P＜0.05). Univariate logistic regression analysis demonstrated that in the ATRS grouping, elevated serum levels of TG, TC and LDL were significantly associated with an increased risk of poor postoperative recovery in AATR patients (all P＜0.05). Similarly, in the AOFAS score grouping, elevated serum levels of TG and TC were significantly correlated with an increased risk of poor postoperative recovery in AATR patients (both P＜0.05). Multivariate logistic regression analysis further identified that high serum LDL level was an independent predictor of poor postoperative recovery in AATR patients (P＜0.05). Conclusion High preoperative serum LDL level is associated with an increased risk of poor postoperative recovery in AATR patients. Therefore, preoperative blood lipid management in AATR patients may have positive effects on postoperative functional recovery.