[Objective] To compare the clinical and radiographic outcomes of bioabsorbable screw and metallic screw for ankle syndesmotic disruptions. [Methods] Eighty five patients were retrospectively observed form October 2014 to September 2017.Three patients were lost follow-up.Metallic screw fixation was used in 43 patients and absorbable screw fixation was used in 39 patients. There was no significant difference in age,gender,cause of injury and classification of fractures between two groups.The The perioperative parameters were compared between two groups. At final follow-up,the clinical parameters of AOFAS scores,OMA scores,VAS scores were assessed.The measurements of radiography ,CT scans ,ankle range of motion and complication were recorded. [Results] All the patients underwent successful surgical procedures.The mean follow-up was(27.3±2.5)months (18 to 43). There was significant difference in operation time between two groups (P<0.05).There was no difference in intraoperative blood loss, radiation exposure time, hospital stay(P>0.05). The absorbable group proved significantly greater than metallic group regarding to AOFAS,OMA, VAS scores and ankle ROM in 3 months postoperation(P<0.05),whereas they were similar at final follow-up(P>0.05).There was no difference in VAS score between two groups at 3 months postoperation or final follow-up(P>0.05).The radiographic parameters of TFO,TCS and MCS had no difference between two groups.There was significant difference in syndesmotic malreduction between absorbable group (18%) and metallic group (5%) (P<0.05). In the absorbable group, one patient had a moderate foreign body reaction. In the metallic group, one had screw breakage and one had superficial wound infection because of diabetes.One patient in each groups had heterotopic ossification. [Conclusion] Absorbable screws provide adequate fixation and functional recovery with avoiding screw removal and lower syndesmotic malreduction.