Hindfoot pain can be caused by a variety of pathologies; most of these can be diagnosed and treated by means of endoscopy. The main indications are posterior tibial tenosynovectomy, diagnosis of a peroneus brevis length rupture, peroneal tendon athesiolysis, flexor hallucis longus release, os trigonum removal, endoscopic treatment for retrocalcaneal bursitis, endoscopic treatment for Achilles (peri)tendinopathy, and treatment of ankle joint or subtalar joint pathology. The advantages of endoscopic hindfoot surgery over open surgery are less morbidity, reduction of postoperative pain, outpatient treatment, and functional postoperative treatment. This two-portal hindfoot endoscopy approach is a safe, reliable, and exciting method to diagnose and treat a variety of posterior ankle problems and offers a good alternative to open surgery.