An ankle block provides sufficient anaesthesia for surgery of the toes, forefoot and midfoot. Only recently have large patient series demonstrated the safety, reliability and high acceptance rate of this anaesthetic technique. Due to its low complication rate, the ankle block can be safely performed even in patients with significant myocardial ischaemia. Moreover, an ankle block with long-acting local anaesthetics guarantees prolonged postoperative analgesia, making this technique especially suitable for ambulatory surgery.