Arthroscopic ankle arthrodesis has recently been shown to be an effective procedure with significant advantages when properly indicated. We report on the results of arthroscopic ankle fusion in 16 patients with idiopathic or posttraumatic osteoarthritis and rheumatoid disease. We used standard ankle arthroscopic technique and simple noninvasive distraction with hanging weights. All 16 patients had a successful fusion at an average of 9.5 weeks postoperatively. Complications included 1 lateral cutaneous neuroma, and 1 patient who required removal of screws because of superficial pain. Postoperative evaluation showed complete resolution of pain in 14 of 16 patients and significant improvement in gait. Fourteen of 16 patients were completely satisfied with the result and cosmesis, and only 1 patient required shoe modification. These results substantiate previous reports that arthroscopic ankle arthrodesis is successful, and where indicated, has significant advantages over the open technique.