The authors reviewed the results of ankle arthrodesis in 68 ankles in 66 patients. The average follow-up period of the patients was five years (range, two to ten years). There were 40 ankles in which internal fixation was used and 28 ankles in which external fixation was used. The two groups were compared to determine the effect of mode of stabilization on outcome. Outcome was measured by time to union, development of complications, and clinical follow-up result. The groups were similar in regards to gender, age, and preoperative diagnosis. The external fixation group had a significantly higher prevalence of complications, including non-union, delayed union, and infection, than the internal fixation group. It was concluded that ankle arthrodesis with internal fixation is better tolerated and has fewer complications than techniques that use external fixation.