With the development of new ski equipment and improvement in skiing techniques and slope grooming, the incidence, mechanism, and type of ankle injuries suffered during skiing have changed. Ankle sprains, peroneal tendon dislocations, Achilles tendon ruptures, and ankle fractures all can happen as the result of skiing. However, the incidence of these injuries has been dramatically lowered in the past two decades. All of these injuries should be treated aggressively to allow the skier to return to skiing. The early functional treatment of acute ankle sprains will return many skiers to activity quickly. With ankle fractures, lateral subluxation of the talus must be diagnosed and will be the determinant as to whether nonoperative or operative treatment is necessary. Open reduction with plating of the fibula and early weight-bearing in a brace allows early functional return to the ankle.