The ankle represents a complex and dynamic region of the musculoskeletal system, encompassing multiple interconnected joints—including the ankle joint and subtalar joint—alongside a sophisticated network of tendons, ligaments, muscles, and nerves. It is essential to have a thorough understanding of anatomy to conduct precise ultrasound evaluations. To optimize scanning and maintain a systematic approach, the ankle is typically divided into four primary anatomical zones: anterior, medial, posterior, and lateral. Often, it is essential to extend the examination into the foot to enhance diagnostic accuracy and support comprehensive pain management strategies. Key ligamentous structures, such as the anterior talofibular ligament and the deltoid ligament, can be visualized using high-resolution ultrasound, thereby improving the precision of structural assessments. The real-time assessment of the Achilles tendon and plantar fascia aids in identifying tendinopathies and fasciopathies in clinical practice. Additionally, focused scanning of the tibial nerve provides valuable insights into entrapment syndromes and neuropathic conditions affecting the ankle and foot. This chapter also addresses ultrasound-guided interventions, including joint injections for the ankle and subtalar joints, tendinitis injections targeting structures like the Achilles tendon, and nerve blocks for the tibial nerve and its branches. Step-by-step scanning protocols and detailed interventional techniques aim to facilitate targeted treatments and improve patient outcomes in the diagnosis and management of ankle-related disorders.