The distal tibiofibular syndesmosis provides stability to the ankle mortise, and it is composed of the anterior inferior tibiofibular, posterior inferior tibiofibular, interosseous, and inferior transverse tibiofibular ligaments and the interosseous membrane. During external rotation of the foot the fibula is translated posteriorly and rotated externally, which results in a high tension of the anterior inferior tibiofibular ligament. This may attribute to the isolated rupture of the anterior inferior tibiofibular ligament. Rupture of the anterior inferior tibiofibular ligament, in its turn, causes instability of the ankle mortise. Reconstructive options for chronic syndesmosis disruption include arthroscopic debridement and screw fixation, arthrodesis of the syndesmosis, advancement of the anterior tibiofibular ligament, reconstruction of the interosseous and anterior inferior tibiofibular ligament. We describe an arthroscopic technique of anatomic reconstruction of the anterior inferior tibiofibular ligaments with tibialis allograft and biodegradable syndesmotic screw fixation.