Triple arthrodesis is a useful operation for the relief of chronic pain and repair of instability and deformity in the rearfoot. Due to the nature of the procedure, preoperative surgical planning is of extreme importance to minimize the incidence of long-term problems associated with rearfoot fusion. Complete intraoperative reduction of the deformity and stable rigid fixation is necessary to avoid complications associated with arthrodesis failure and any long-term problems in neighboring joints, particularly in the ankle joint and joints of the mid- and forefoot. Even with good reduction and fixation, there is still the possibility of nonunion or painful pseudoarthrosis. Gait alterations that may lead to residual pain and degenerative joint disease can also be seen. While these problems can occur, they might not be as symptomatic as the patients' preoperative complaints. The surgeon, however, needs to be aware that these conditions exist and may need to be addressed in the long-term care of the patient.