Displaced intra-articular calcaneus fractures can be life-altering injuries with long-term disability. They occur from high-energy axial loading and have an increased likelihood of concomitant injuries. Preoperative imaging should be approached in a systematic fashion with careful attention paid to each CT reformat. Principles of fixation follow AO principles of anatomic articular reduction, careful soft tissue handling, stable internal fixation, and restoration of calcaneal architecture. A sinus tarsi approach can allow early surgical management and minimize wound healing complications. Fixation of the posterior facet is performed working from medial to lateral. Using dual C-arms facilitates fluoroscopic evaluation while minimizing patient or C-arm repositioning. A Broden’s view is used to assess joint reduction while Harris heel and AP calcaneal profile views can be used to judge heel alignment. Postoperatively patients need careful wound monitoring with early joint range of motion (ROM) despite a prolonged period of weight-bearing restriction.