Arthroscopic surgery of the ankle allows the direct visualization of all intra-articular structures of the ankle without an arthrotomy or malleolar osteotomy. Technological advances and a thorough understanding of anatomy have resulted in an improved ability to perform diagnostic and operative arthroscopy of the ankle. The decreased morbidity and faster recovery times make it an appealing technique compared with open arthrotomy. A keen understanding of the anatomy of the foot and ankle is critical to safe performance of arthroscopic procedures and prevention of complications.