The value of arthroscopy as a diagnostic and operative tool has been firmly established in the management for disorders of the knee joint. Its application, however, to intraarticular problems of the ankle is not widely advocated. We reviwed our experience with diagnostic and operative arthroscopy of the ankle. Arthroscopy was performed in 20 ankles from August, 1990 to October, 1991. Age range of the patients was 17 to 63 years. Follow-up period was from twelve months to twenty two months, with an average follow-up period of fourteen months. The indications for arthroscopic surgery in that group of patients were based on such disabling clinical symptoms as pain or clicking sensations aggravated by ambulation, painful limitation of motion, and a definite presence of intra-articular loose bodies and osteochondral lesions. Rheumatoid arthritis was observed in six cases; degenerative arthritis in four cases; osteochondral fracture of talar dome in three cases; posttraumatic arthritis in two cases; osteochondral loose bodies in two cases; lateral impingement syndrome in two cases; synovial impingement syndrome in one case; pathologic medial plica syndrome in one case; simple bone cyst of talus in one case; osteochondral ridge of talar dome in one case; tuberculous arthritis was found in one case. Treatment consisted of debridement of osteochondral lesions, removal of loose bodies, curettage and bone graft, synovectomy, debridement of synovium, shaving of subchondral bone and arthrodesis of the ankle joint. The results were assessed subjectively and objectively. Satisfactory overall results were obtained in 80% of cases. The complication was found in one case, which was the development of sinus tract. This study suggests that arthroscopic surgery has a definite role in the management of intra-articular lesions of the ankle.