Initially deemed unsuitable for arthroscopy due to complex anatomy, the ankle joint became accessible following Takagi’s pioneering work in 1939. Since then, ankle arthroscopy has advanced significantly and can be employed for various procedures although it is most commonly used for procedures like arthroscopic debridement of the ankle joint. For the purpose of this review, arthroscopic debridement of the anterior ankle impingement syndrome will be discussed. This syndrome involves pain during dorsiflexion of the ankle due to soft tissue or bony impingement. The anterolateral variant, often from inversion injuries and chronic lateral ankle instability, results from hypertrophied synovium, scar tissue, or ligamentous thickening. Conversely, the anterior bony impingement of the ankle is often from bony spurs within the joint secondary to repetitive microtrauma between the anterior chondral margins of the ankle joint. These bone spurs are classically seen on the anteromedial corner of the ankle joint which explained why anterior ankle bony impingement is also sometimes known as anteromedial impingement.