An old injury to the anterior talofibular ligament does not necessarily require surgery. The anterior talofibular ligament is one of the ligaments of the talus calf joint. This ligament is located on the lateral side of the joint, starting from the anterior border of the ankle and ending at the anterior aspect of the talar facet and the lateral aspect of the talar neck, and is easily damaged during plantarflexion and pronation. If the injury is mild, it is usually treated conservatively with ultrasound, ultrashort wave, shock wave and other physical therapies together with medications such as ibuprofen, diclofenac, etc. If the injury is severe, it has already caused significant damage. If the injury is severe and has caused significant ankle instability, or if there is persistent severe pain and swelling, surgery may be indicated. Prompt consultation and timely standardized treatment are recommended after an injury to the anterior talofibular ligament.