As early treatment of septic arthritis of the ankle significantly affects the outcome [Changgeng Yi, Lee CH, Chen YJ, Ueng SW, Hsu RW. Septic arthritis of the ankle joint. Chang Gung Med J 2000;23(7):420–6], this case report highlights the important role of early Magnetic Resonance Imaging (MRI) in the management of such cases. Therefore, early magnetic resonance imaging or if not available an intra-operative contrast angiography of the ankle and subtalar joints should be considered in all cases of septic arthritis of the ankle.