Anterior ankle abutment can be problematic for both athletes and for persons whose occupations require repeated loading of the anterior ankle joint. Nonoperative care is often not satisfactory for the individual who demands painfree activity. Because the presence of anterior osteophytes has been shown to represent the early stages of degenerative disease of the ankle joint, operative intervention may provide the best option to decelerate the arthritic process. Open ankle débridement or arthroscopic débridement can be used to remove the osteophytes and inspect the ankle joint. Care must be taken to examine the joint adequately to ensure that the impingement is not caused by lateral ankle instability. Failure to recognize the cause of anterior ankle impingement will result in an unsatisfactory result. When the proper diagnosis is made, surgery can result in pain-free motion that allows the individual to return to painfree activity.