Introduction:Ankle arthrodesis has emerged as a definitive treatment for various complications affecting the distal third of the leg. The operation was first described by Edward Albert in 1879 and refined by John Charnley until internal fixation became a viable option. It has been shown to be an effective treatment option for pain relief and correction of hindfoot malalignment. The tibiotalocalcaneal arthrodesis(TTCA) is used as a salvage procedure for the ankle joint in patients with changes in the subtalar joint. Principles of treatment by fusion are removal of cartilage till bleeding of subchondral bone, keeping the joint surfaces congruous, proper positioning of the foot and ankle and stable fixation.Objective:To overcome functional outcome in tibiotalocalcaneal arthrodesis using retrograding intramedullary nailing.Materials and Methods:A series of 10 patients having subtalar arthritis with degenerative changes in the ankle joint (tibiotalar arthritis) were selected. For this study, 10 patients (06 males and 04 females) were included with median age group of 55 years (45-70 years). All the patient were treated with tibiotalocalcaneal arthrodesis using retrograde intramedullary nailing at our institute (Navodaya Medical CollegeHospital and Research Center). All of them were followed up for the period of 1 year. The main outcome measurements included the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot scale, radiologic assessment and clinical examination.Results:Bony union was achieved in 90% of subjects, the mean time to union being 6.4months (range, 4.4 to 9.2 months). “Structural bone graft was used in all patients”. Postoperative radiologic results showed a good hindfoot alignment in all patients. The complications were, two cases of delayed wound healing and one case of non-union which underwent revision surgery. The mean post operative AOFAS ankle-hindfoot scores were 72.9 (range, 45 to 88) points, respectively.Conclusion:It was concluded that TTCA using retrograde intramedullary nailing is a good mode of fixation with good functional outcome where both the tibiotalar and subtalar joints needs to be fused.