Ankle instability and ankle impingement are well-known complications of an ankle sprain. Both diagnosis are made primarily by history and physical examination. Ankle instability may resolve with physical therapy, but can require surgical reconstruction. Anatomic reconstruction is preferred whenever possible. Ankle impingement usually requires surgical treatment. Anterior soft tissue impingement and mild bony impingement confined to the tibia can be treated arthroscopically, whereas more severe anterior bony impingement and any form of posterior impingement require an open procedure. Ankle ligament reconstruction and surgical treatment of ankle impingement are reliably effective procedures.