A xanthoma of the Achilles tendon is a rather rare and is associated with a specific disturbance of lipid metabolism. It is not a true tumor, but rather a reactive histiocyte proliferation, often occuring in response to alteration in serum lipids. Xanthomas may occur in all of the five subtypes of essential hyperlipidemia, in disease states associated with a secondary hyperlipidemia, and in the normolipemic state. We experienced 2 cases of bilateral xanthoma of the Achilles tendon in normolipemic state which were treated by total resection and heel cord reconstruction and conservatively.