Background: Persistent instability following an acute lateral ankle sprain has been reported to vary in incidence from 15% to 48%. Surgery is indicated when conservative management fails to produce a satisfactory functional outcome. Associated intraarticular lesions of talus or extraarticualr lesions like peroneus Brevis tendon injuries can impact the functional outcome of lateral ankle reconstruction. The aim of this study was to report our short-term experience and treatment of concomitant lesions in chronic lateral ankle instability.Methods: 18 patients, aged 21 to 45 years with recurrent ankle sprain and lateral ankle instability who had not responded to at least 3 months conservative treatment and had underwent direct lateral ligament repair were studied. All the patients received ankle arthroscopy and exploration of peroneus Brevis tendon before repair of anterior talofibular and calcaneofibular ligaments with 14 months (6-22 months) follow-ups. The cases were evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) score.Results: The mean duration of injury was 19 months. In the diagnostic ankle arthroscopy, 6 patients had some degree of talar chondral lesions, two requiring shaving and drilling. Preoperatively, all patients had poor scores (<50).Postoperatively, 14 (79%) ankles obtained excellent and 4 (21%) good scores.Conclusion: Chronic lateral ankle instability is often associated with concomitant injuries to peroneus Brevis and talar cartilage. Direct repair of anterior talofibular and calcanofibular ligaments is an effective procedure.