Ankle fractures are the most common injuries treated by orthopedic surgeons. The age, physical condition, demands and lifestyle of the patient must be considered in assessing treatment options. Principles of treatment involve a careful understanding of the injury to both bones and soft tissues. This always involves obtaining a proper history, a careful physical examination and obtaining appropriate imaging studies. Anatomic reduction of articular surfaces, restoring metaphyseal stability, preserving blood supply and allowing early motion are the goals of treatment. Lauge-Hansen classification and Danis-Weber classification are two classifications of ankle fractures. Displaced fractures, and manipulation under anesthesia (MUA) and cast immobilization are the management of ankle fractures. Fibular fixation, medial malleolar fractures, posterior malleolus and osteoporotic fractures are the surgical treatment of ankle fractures. Malunion and post-traumatic arthritis are the specific complications of ankle fractures. 36 well-labeled and well-colored figures are also provided in this chapter.