Impingement is a clinical syndrome of end-range joint pain or motion restriction caused by the direct mechanical abutment of bone or soft tissues. Impingement syndromes at the ankle may occur after acute macrotrauma or repetitive microtrauma. Modern imaging modalities can show underlying diseases and anatomic variations and assist with patient management. Implicit in the definition of impingement as a clinical syndrome is that the diagnosis remains clinical, because imaging changes alone do not reliably predict symptoms or clinical relevance. This article reviews the anatomy, pathogenesis, clinical features, differential diagnosis, imaging, and management of various impingement syndromes around the ankle.