Medial and lateral malleolus have an important role in ankle joint stability. Although medial and lateral malleolus can be fractured individually, they also can be fractured simultaneously. Fracture displacement, the harmony of the talus between malleolus, accompanying soft tissue injuries and general condition of the patient are all important to decide the type of treatment. If the fracture is undisplaced and the fracture line does not reach tibial plafond, medial malleolus fractures can be managed conservatively. If the fibula is not shortened, the fracture is not displaced, and if there is not accompanying syndesmosis or deltoid ligament injury, lateral malleolus fractures can be also managed conservatively. Cartilage injuries in talus or tibial plafond may accompany these fractures. The condition of the soft tissues has to be considered if there is need for surgical treatment.