Management of syndesmotic injuries of the ankle remains controversial. A postal questionnaire was administered to 310 Orthopaedic consultants in the United Kingdom to explore these issues. One hundred and ninety seven (63.55%) replies were received. A large number of surgeons use intra-operative hook test as an aid to assess syndesmotic stability (68.8%). A clear majority favoured the use of a syndesmotic screw as the preferred method of fixation (97.4%). The opinion on technique was divided over issues including number of cortices fixed, position and type of screw used. Most surgeons (88.4%) do not compress the syndesmosis while inserting the screw. Very few surgeons (8.5%) allow full weight bearing immediately after surgery. The survey establishes an overview of current practice of management of syndesmotic ankle injuries.