Background:The effect of trigger point dry needling (TDN) on myofascial trigger points (MTP) in Achilles tendinopathy are unknown. Objectives: To determine the feasibility of a large randomized controlled trial (RCT) to compare the effects of TDN to exercise in a patient population with Achilles tendinopathy. Methods: This single-factor, pretest-posttest control group design included 22 subjects between the ages of 24 and 65 years with Achilles tendinopathy. Subjects were randomly assigned to either a control group (MT+Ex) or experimental group (TDN+MT+Ex). Subjects in both groups completed 8 physical therapy treatment sessions over 4 weeks. The intervention for the TDN+MT+Ex group included TDN to MTPs in the gastrocnemius, soleus or tibialis posterior each session while the same soft tissue mobilization and exercise program was conducted in both groups. Results: Within group analysis was performed for each group at 4 week and 90 day follow up. Significant improvement (p < .05) was achieved for FAAM, NPRS, pain pressure threshold and strength in both groups at 4 weeks and 90 days. The GROC was significant for MT + Ex at 90 days. The MCID for the FAAM, GROC were surpassed in both groups at 4 weeks and 90 days. NPRS surpassed the MCID for the MT + Ex group at 4 weeks. Conclusion: A large RCT to investigate the effects of TDN on MTP in Achilles tendinopathy is feasible with modifications.