To prevent worsening of ankle valgus and functional repercussions, a distal inter-tibiofibular osteochondroma can be removed using a transfibular approach. We evaluated the difference between the preoperative and postoperative tibiotalar tilt at the last follow-up examination and the clinical and radiologic outcomes. We included 10 consecutive ankles that had undergone removal of an osteochondroma using a transfibular approach. The mean patient age was 10.6 years. One ankle was lost to follow-up. The mean postoperative follow-up duration was 5.9 years. The mean preoperative and postoperative tibiotalar tilt was 7.2° and 7.1°, respectively, with no significant difference. The mean postoperative American Orthopaedic Foot and Ankle Society score was 92.4. Tibiofibular synostosis developed in 7 cases. Osteochondroma recurred in 1 case. The transfibular approach stabilizes ankle valgus and is associated with good functional outcomes. However, it is an extensive procedure associated with postoperative synostosis and, thus, should be considered primarily when surgical access for an anterior approach is limited.