Several techniques for ankle arthrodesis have been described. Many of them are not suitable in patients with severe rheumatoid arthritis because of multiple joint involvement, osteoporosis, and increased risk of infection caused by poor skin conditions. The arthroscopic technique described in this article has been used in 7 patients with seropositive rheumatoid arthritis and 1 patient with seronegative rheumatoid arthritis (10 ankle joints; 2 patients surgically treated bilaterally). All patients successfully obtained ankle joint arthrodesis. The mean time to fusion was 10 weeks (range, 6-12 weeks). There was a 100% fusion rate without any complication.