Objective To review the progress in the diagnosis and treatment of distal tibiofibular syndesmosisinjury. Methods Different kinds of documents were widely collected, current developments of the diagnosis and treatmentof distal tibiofibular syndesmosis injury were summarized. Results The disease history (damage mechanism), cl inicalexamination, and imaging examination (X-ray, CT scan, and MRI) can assist the diagnosis of distal tibiofibular syndesmosisinjury. Patients with unstable distal tibiofibular syndesmosis injury needs active surgery treatment, and the princi ple isanatomical reduction and fixation so as to avoid the instabil ity of the ankle joint, long-term chronic pain, and traumaticarthritis. Conclusion The diagnosis of distal tibiofibular syndesmosis injury is still lack of specific quantitative parameters, socl inical study for large sample is needed to explicit the effectiveness.