Avascular necrosis of the foot and ankle is a rare but important cause of pain and functional impairment. This process can occur in any bone in the foot and ankle; however, it mostly occurs in characteristic locations such as sesamoids, metatarsal heads, navicular bone and especially talus. It is important to understand the basic radiographic findings in the treatment of these lesions. Although studies have been conducted with various imaging methods, magnetic resonance imaging is the most sensitive and specific method for the detection and characterization of this abnormality in the diagnosis of most diseases. Treatment options range from conservative treatments such as follow-up and weight-bearing restrictions to surgical treatment including percutaneous piercing, ankle arthrodesis and total ankle arthroplasty. More research is needed to further identify patients at high risk of developing these sequelae of ankle fractures and to assist with treatment and surgical decision-making.