Objective To discuss and study the significance of transtarsal sinus incision approach in the treatment of calcaneal fracture. Methods: A total of 66 patients with calcaneal fracture were enrolled. Input 2020.08 to 2021.07. Group by random number table method. 32 cases were treated by "L" incision approach to the lateral calcaneus. Thirty-four patients were treated by tarsal sinus incision approach. The reduction effect of each group was evaluated. Results: After surgery, the experimental group was better than the reference group in foot function, operation, calcaneal recovery, pain stress index, quality of life and other aspects, P < 0.05. Conclusion: The transtarsal sinus incision approach has a significant effect in the treatment of calcaneal fracture. In addition to shortening the operation time, it can also improve the foot function of patients, accelerate the speed of calcaneal recovery, and promote the quality of life of patients.