Ankle arthrodesis is used to treat patients with joint destructive processes that are not responsive to nonoperative measures. The procedure has traditionally been performed using open techniques. Recently, arthroscopic techniques have been applied to successfully fuse the ankle joint. This paper describes the indications for the procedure, the operative technique, and postoperative care. Arthroscopic ankle arthrodesis is a minimally invasive procedure that reliably results in a high rate of fusion with a low incidence of complications.