The ankle is one of the most commonly injured joints during sport, accounting for almost 30% of all musculoskeletal injuries. These result in a spectrum of pathology varying in severity and involving a number of structures around the hind foot. The most common pathologies include lateral ligament and syndesmosis injuries, impingement and osteochondral lesions of the talus. Most of these injuries will resolve with non-operative management, however, more severe injuries may never fully settle and will require surgical intervention. There have been recent developments in the surgical management of these conditions and this review article will focus on the recent advances in the understanding of these injuries and aim to discuss the up-to-date management options.