This chapter presents the embryological development, the bony anatomy and soft tissue architecture. This forms the basis for understanding the biomechanics and kinetics of the foot and ankle joints. Finally, a review of most common surgical approaches used in trauma and elective foot and ankle surgery is presented. The normal human foot consists of 26 bones. Subtalar joints, midtarsal joints, other intertarsal joints, tarsometatarsal joints, and interphalangeal joints are the various groups of joints of the foot. Ligaments, and muscles and tendons are the soft tissue components of the foot. The sole of the foot is a specialized structure. It functions to spread weight from a relatively small bony surface area to the larger skin surface, thus acting as a shock absorber. Ankle joint, and fascia and the neurovascular supply of the foot and ankle are the surgical anatomies of the ankle. Anterior approach, anterolateral approach, medial approach, a lateral approach, posterior approach and posterolateral approach are the different surgical approaches to the ankle.