Ankle osteoarthritis is a growing problem in health care, with 1 % of the world’s adult population being affected. Previous trauma is the most common origin of ankle osteoarthritis. In the current literature, there is no evidence whether sport activities accelerate or prevent the development of ankle degenerative changes. Different surgical approaches have been described for the treatment of ankle osteoarthritis based on osteoarthritis stage. The treatment options range from joint preserving procedures (e.g. open or arthroscopic debridement, joint distraction arthroplasty, and supramalleolar osteotomies) to joint sacrificing procedures (e.g. total ankle replacement and ankle arthrodesis). While numerous studies have addressed clinical and radiographic outcomes in patients who underwent surgery for ankle osteoarthritis, there is scant literature addressing the role of sports participation of patients with ankle osteoarthritis before and after surgical treatment. In general, low impact sports can be recommended postoperatively. However, further prospective clinical studies are needed to identify whether sport activities can be identified as risk factors for treatment failure or for poorer postoperative results.