In the past two decades there has been a great improvement in the knowledge of Lisfranc injuries, but some questions still remain unanswered. X-ray and CT scan are important for diagnosis but clinical examination is still fundamental to determine treatment. The so-called “minor lesions”, source of future problems such as pain and limping, have been currently discussed. Open reduction and internal fixation is the best approach to Lisfranc injuries, but many authors affirm that conservative treatment renders the same results. Crush injuries and the resulting soft tissue problems, which may potentially develop into sepsis and avascularity, have to be well managed to achieve a good final outcome. Compartment syndrome is a major problem in Lisfranc injuries, requiring immediate fasciotomy and administration of judicious systemic antibiotics. Late complications such as deformities and arthritis are the goals of the treatment, which also includes pain relief, correction of deformity, and preservation of the function.