Abstract: Objective To study the clinical effect of retrograde drilling on osteochondral lesions of talus. Methods Thirty-one patients (22 males and 9 females) with osteochondral lesions of talus at the age of 21-64 years (mean 64 years) admitted to our department from March 2008 to December 2010 were included in this study. The lesions with a diameter ≤1 cm were classifed as grades Ⅰ and Ⅱ according to the Mintz classifcation and underwent retrograde drilling. The pain and joint function of the patients were assessed according to the VAS and AOFAS after operation. Results The VAS score was signifcantly lower whereas the AOFAS score was signifcantly higher after operation than before operation (3.6±1.3 vs 6.7±1.6, 77.4±10.6 vs 55.1±13.1, P＜ 0.05). Conclusion The clinical effect of combined arthroscopic debridement and retrograde drilling on grades Ⅰ and Ⅱ osteochondral lesions of talus is rather good.