Osteochondral lesions of the talus range from those confined to the hyaline cartilage covering the articular surface to those involving the subchondral bone. The lesion may not be apparent on the surface of the cartilage or it may be confined to the subchondral bone without cartilage involvement. These complex presentations often necessitates the use of computed tomography and magnetic resonance imaging to delineate the exact nature of the lesions. It has been shown that the frequency of osteochondral lesions increase following repetitive ankle sprains. Although the etiology is not well understood, both traumatic and atraumatic causes are thought to be effective. Nevertheless, early diagnosis and treatment of these lesions have improved considerably thanks to the developments in imaging techniques. It seems that arthroscopic chondral reconstruction methods using autologous chondrocyte and osteochondral transplantations will gain much interest in the near future.