Anterior ankle arthroscopy is the most commonly performed foot and ankle arthroscopy. By means of the anterolateral and anteromedial portals, the anterior compartment of the ankle joint can be approached easily. Different posterior portals had been described to reach the posterior ankle compartment. With the patient in prone position and the combination of anterior and posterior portals, the medial and lateral gutters of the ankle joint can be reached together with the anterior and posterior compartment. This is useful for complete synovectomy of the ankle joint.