An assessment of 10 patients with osteochondral lesions of the medial or lateral articular surface of the talar dome was based, first on subjective symptoms and second, on an analysis of weight-bearing anteroposterior and lateral X-rays of both ankles. The mean period of follow-up was 15 years 11 months (range 7 to 28 years). In 5 of the 6 patients treated conservatively, radiologic assessment showed that the lesion had failed to heal, but nevertheless in each instance the ankle joint was relatively asymptomatic. Talocrural osteoarthrosis developed in only 2 ankles and was considered to be an uncommon complication in those joints treated either conservatively or by excision of the osteochondral fragment.