This study aimed to assess the diagnostic value of three types of MRI sequences and to observe the clinical outcomes of arthroscopy surgery for ankle joint impingement syndrome. Ankle joint impingement syndrome was confirmed by FSE-T2WI, FSE-PDWI, and FS-3D-FISP MRI in 23 patients with arthroscopically proven ankle impingement. All 23 patients underwent arthroscopic surgery and the ankle joint function was evaluated before, 1 week after and 6 months after the operation. The patients were followed-up for 12-64 months (average 28 months). There was no significant difference in ankle function score between preoperatively and 1 week postoperatively, but 86.96 % patients got overall excellent or good scores 6 months after the surgery, significantly higher than before the surgery. The FS-3D-FISP MRI exhibited a good consistency with arthroscopic examination and had higher sensitivity and specificity for the diagnosis of ankle impingement than FSE-T2WI and FSE-PDWI. In summary, arthroscopy surgery for ankle impingement syndrome has several advantages such as good efficacy, minimal trauma, quick recovery, and much less complications. The preoperative FS-3D-FISP MRI allows accurate diagnosis and positioning of ankle impingement syndrome.