BACKGROUND: Prone ankle and subtalar arthroscopy is challenging in part due to the limited working space in these joints. MATERIALS AND METHODS: Fourteen patients undergoing prone posterior arthroscopy with a novel skeletal traction method were reviewed and the technique detailed. RESULTS: No complications were observed in 14 patients treated with a minimally invasive skeletal traction technique for prone ankle and subtalar arthroscopy and 38 patients treated with the same traction device during supine ankle arthroscopy. CONCLUSION: Minimally invasive skeletal traction can be used safely for prone posterior ankle and subtalar arthroscopy.