Ankle arthritis(AA)is one of the most common diseases in foot and ankle surgery.Ankle arthrodesis and total ankle arthro-plasty(TAA)are the primary surgical options.Recent advancements in prostheses,surgical techniques,and personalized surgical instru-ment systems have extended lifespan of prostheses and improved surgical precision,enhancing TAA outcomes.TAA is now a widely ac-cepted treatment for end-stage AA,with broadening indications.However,there is currently no expert consensus or recommendations on common clinical issues such as the optimal age range for TAA candidates,the impact of preoperative deformity on the choice and prognosis of TAA,and decision-making for soft tissue release and reconstruction.Therefore,led by the Research Center for Foot and Ankle Arthritis of Beijing Jishuitan Hospital,National Center for Orthopaedic,this consensus was developed following the principle of evidence-based medicine,and focusing on topics such as the indications and contraindications for TAA,preoperative preparation,intra-operative technical points,perioperative management,postoperative rehabilitation,and follow-up through multiple meetings and ques-tionnaires.It serves as a reference and a practical guide for foot and ankle surgeons in their clinical practice.