PURPOSE: The purpose of this study was to assess the incidence of iatrogenic articular cartilage injuries during ankle arthroscopy and to determine the factors that caused them. The hypothesis of this study was that the incidence of iatrogenic cartilage injuries produced during ankle arthroscopic procedures is high and directly related to the arthroscopic technique. METHODS: All consecutive records from ankle arthroscopies performed between 2008 and 2010 were reviewed. Arthroscopic arthrodesis of the ankle was excluded from the study. Iatrogenic articular cartilage injury was defined as any cartilage injury that occurred during the arthroscopic procedure. RESULTS: The final number of ankle arthroscopic procedures reviewed was 74. There were a total of 23 iatrogenic lesions of the cartilage, for an overall complication rate of 31%. The two most common injury locations were the anterolateral and central area of the talus. The cartilage lesion was superficial in 78.2% of injuries (24.3% of all patients), and deep in 21.8% of injuries (6.7% of all patients). Of the 23 injuries found, 65% of them were sustained during the therapeutic portion of the arthroscopic procedure and the remaining 35% occurred during the portal creation portion of the procedure. CONCLUSION: The incidence of cartilage injury during ankle arthroscopy is high. However, severe damage was found in only 6.7% of ankle arthroscopies. LEVEL OF EVIDENCE: Retrospective case series, Level IV.