The purpose of this report is to introduce the procedure of ankle arthrodesis using an anterior sliding inlay vascularized tibia flap and to present three cases. The distal end of the tibia was elevated on the pedicle of the tibialis anterior vessels. The vascularized tibial flap was shifted distally and inserted into the graft bed in the talus to form a bridge between the tibia and the talus. The talotibial joint was completely fused 2 months after surgery. Three months were required before the patients could walk bearing full weight. Ankle arthrodesis using an anterior sliding inlay vascularized tibia flap is an easy procedure to perform and is indicated for both the treatment of primary and secondary ankle arthritis. © 2010 Wiley-Liss, Inc. Microsurgery, 2011.