The anterior ankle impingement syndrome is a clinical pain syndrome that is characterized by anterior ankle pain on (hyper) dorsiflexion. The plain radiographs often are negative in patients who have anteromedial impingement. An oblique view is recommended in these patients. Arthroscopic excision of soft tissue overgrowths and osteophytes is an effective way of treating anterior impingement of the ankle in patients who have no narrowing of the joint space. For grade II lesions (osteophytes secondary to arthritis with joint space narrowing) arthroscopic treatment is a good option, because no other therapeutic option is available with the exception of an arthrodesis or prothesis.