Ankle fractures are common injuries in orthopaedic trauma and sports medicine. Treatment stratification indicating non-operative or operative treatment remains controversial. The Lauge-Hansen, AO/OTA, as well as the Weber classifications are commonly used in clinical routine to describe the fracture pattern and characteristics. Fracture characteristics, as well as co-variables such as comorbidity, patient compliance, level of mobility among others, are relevant to further decision making. Fracture stability, which can be tested by dynamic or static radiographic analysis, is a determinant of conservative treatment. In cases where stability criteria are fulfilled, functional, non-surgical treatment can be initiated. Non-operative treatment includes plaster, cast, splint, brace, or air-cast immobilization combined with a variable degree of weight-bearing supported by crutches. Functional outcome following non-operative treatment has been demonstrated to be generally good if joint congruity is preserved. Complications are uncommon.