Patients with arthrosis of the ankle are seen routinely in the practice of orthopaedic surgery. Although the etiologies of the arthrosis may be varied, the treatment options are similar. These options vary with the severity of the symptoms, the findings on examination and radiographs, and the physical demands of the patients. Although there are many different conservative and surgical options available, it generally is accepted that arthrodesis of the ankle is the surgical treatment of choice for patients with significant symptoms that do not respond to conservative measures. Although ankle arthrodeses have been performed for more than 100 years, there is still little agreement as to the best method to achieve the best results. Various treatment options, conservative and surgical, available to treat patients with arthrosis of the ankle are reviewed.