Ankle arthrodesis is considered the standard treatment for final stage arthrosis of the ankle. Indications for ankle arthrodesis include: posttraumatic, degenerative, postinfectious and rheumatic arthritis, neuromuscular conditions, avascular necrosis of the talus, salvage of failed total ankle arthroplasty, and tumors about the ankle. Good evaluation of the painful or malaligned ankle joint is essential. Several techniques are available including: External fixation with various external fixator devices, internal fixation with various implants, and the arthroscopic or the “mini-open” arthrodesis. With good technique and carefully selected patients, ankle arthrodesis achieve fusion in 80 to 90%. Complication rate is reported as high as 60% following ankle fusion. The most common include: nonunion, malunion, infection, and wound complications. Revision arthrodesis achieves good results with progress in fixation technology and a complete preoperative assessment.