Abstract: Objective To observe the effect of arthroscopy assisted ankle fusion on operation conditions, functional scores of American Orthopedic Foot and Ankle Society(AORAS)and postoperative complications in patients with ankle osteoarthritis. Methods A total of 140 patients with ankle osteoarthritis who were admitted to our hospital were selected and divided into two groups according to the odd and even admission number, with 70 cases in each group. The observation group was treated by arthroscopy assisted ankle fusion and the control group was treated by open ankle fusion. The pain visual analogue(VAS)scores, AOFAS ankle-rear foot function scores and ankle joint scoring criteria(Kofoed)were compared between the two groups before and after treatment. The perioperative indexes and postoperative complications in both groups were observed. Results The intraoperative blood loss of the observation group was significantly less than that of the control group ［(50.38±- 5.94)mL vs.(87.62±9.05)mL, P<0.05)］. The surgical time, postoperative joint fusion time and length of hospital stay were(127.32±13.67)min,(10.25±1.64)weeks,(6.12±0.68)days, which were significantly shorter than(141.85±15.26)min,(14.37±1.58)weeks,(8.05±0.83)d in the control group(P<0.05). The VAS scores of observation group at 3 and 6 months after surgery were significantly lower than that of the control group(P<0.05). There was no significant difference in the AOFAS ankle-rear foot function score between the two groups before surgery and at 3 months after surgery(P>0.05). The AOFAS ankle-rear foot function score at 6 months after surgery of the observation group was significantly higher than that of the control group(P<0.05). Scores of pain, function and activity of the observation group were significantly higher than those of the control group at 3 and 6 months after surgery(P<0.05). The total incidence of postoperative complications in the observation group was significantly lower than that in the control group(15.71%vs. 40.00%, P<0.05). Conclusion Arthroscopic assisted ankle fusion for patients with ankle osteoarthritis can reduce the risk of surgery, relieve postoperative pain, promote function recovery, and shorten the recovery process.