Abstract: The total ankle joint prosthesis has been going on for more than 50 years, and it has also evolved from the first generation to the present third generation. In recent years, the improvement of prosthesis design and prosthetic materials and the application of Patient-specic instruments have made the prosthesis more stable and more accurate, and the indications for total ankle replacement have been gradually expanded in recent years. The research progress of artificial total ankle replacement prosthesis design was reviewed in this paper.