Total ankle arthroplasty (TAA) is used as an alternative treatment for end-stage ankle arthritis. Early clinical results of TAA were poor, but with the advent of third-generation prostheses and the development of surgical techniques, better clinical results have been achieved. Currently, there is a trend of gradual expansion of the indications for TAA. The surgical approach is still mainly the anterior approach, and several other approaches have emerged. The overall survival rate of the prosthesis is satisfactory, but there is some variation from region to region. The clinical advantages of computer-assisted TAA are not obvious. There is no uniform treatment for TAA after failure, and revision arthroplasty or conversion to fusion can be performed according to the actual situation.