Objective: The aim of current study was to investigate the clinical effects of tibiotalocalcaneal arthrodesis using a straight retrograde intramedullary nail. Methods: From June 2016 to July 2019, a total of 16 patients underwent tibiotalocalcaneal arthrodesis with straight retrograde intramedullary nail in our hospital were retrospectively analyzed. There were 16 patients with an average age of 61.3 years (range, 20-75 years). There were 6 cases of tibiotalar and subtalar joint osteoarthritis, 3 cases of traumatic arthritis, 4 cases of talar necrosis and 3 cases of Charcot neuroarhropathy The outcome measurements included the American Foot and Ankle Society ankle-hindfoot scale, Visual Analogue Scale and radiologic assessment. Results: The mean follow-up was 31.4 months(range, from 13 to 50). Bony union were achieved in all the patients after a mean time of 3.7 months (range, from 2.5 to 7 months). Two patients had superficial wound infection and one patient had delayed healing. The mean AOFAS ankle-hindfoot score and VAS score were 71.3 and 1.61, respectively. Conclusion: TTC fusion with straight retrograde intramedullary nail is a successful method for the treatment of severe ankle and hindfoot deformities.