Ankle arthroscopy has grown in popularity over the past decade as a diagnostic and therapeutic procedure. We assessed 24 patients who underwent ankle arthroscopy during the two year period 1991-1993. In 18 cases a mini-arthrotomy was performed based on the arthroscopic findings. All patients were reviewed at an average of 26 months and a detailed evaluation was carried out according to an objective scoring system which grades five parameters; pain, swelling, stiffness, limp, and activity level. Twenty-two patients (92%) had good or excellent results. There were two complications transient tarsal tunnel syndrome and reflex sympathetic dystrophy. There were no neurovascular complications. This series represents an initial experience and illustrates that ankle arthroscopy provides a safe and effective method of diagnosis and treatment with few complications. Further advances in instrumentation and distraction techniques will reduce the need for open arthrotomy and should expand the indications for the procedure.