Anterior ankle impingements include a wide range of anterior joint pathology, both osseous and/or soft tissue abnormalities. The etiology and pathoanatomy are not completely clear, and diagnostic tools and treatment options are discussed. Anterior ankle impingement is a common cause of chronic ankle pain, and, given its association with sport, it was originally named as “athlete’s ankle” or “footballer’s ankle.” Treatment with open surgery has provided good results, but, at present, the literature indicates anterior arthroscopy equally effective to treat this condition with a minor rate of complications. A comprehensive understanding of diagnosis and surgical technique influence patient outcomes.