Background: Charcot neuroarthropathy is a severe disease involving several joints but most commonly affecting the foot and ankle.Charcot arthropathy is a serious late complication of many pathologies like diabetes mellitus, syphilis, and meningiomyelocele. It may result in fractures, permanent deformity, and even limb loss. Ankle fusion with internal fixation has high morbidity and complications. External fixation can provide stability to the joint and correction of the deformity with less risk for surgical complications.Objectives: To assess the clinical and functional outcomes of ankle joint arthrodesis using external fixator in patients with severe Charcot ankle arthropathy. Materials and Method:This study is descriptive cross-sectional hospital-based study that involved an 18 patients with advanced Charcot arthropathy of the ankle joint. Ankle fusion with Ilizarov external fixation was done for all patients. The patients were followed, and the frame was removed after clinical and radiological evidence of union were obtained. The American Orthopedic Foot and ankle Society scale (AOFAS) was assessed before surgery and one year after surgery. The post-operative complications and patient satisfaction also evaluated. The Data was analyzed using IMP SPSS version26.Results: Number of patients was 18, 14 males and 4 females. The most frequent age group was more than 50 years (11 patients, 61.1%). Preoperative AOFAS score was poor for all of the patient (100%). The postoperative AOFAS score was improved, 6 patients (33.3%) obtained excellent result, 5 patients (27.8) good, 4 patients (22.2) fair, while 3 patients (16.7) remained poor. 13 patients (72.2%) were satisfied with the outcome while 5 of them (27.8%) were unsatisfied. The most frequent complication rate was for pin track infection which occurred in 6 patients (33.3%). Conclusion:Fusion of the ankle joint with ring external fixator is useful treatment option for Charcot-arthropathy instability and deformity, particularly in cases where internal fixation methods are ineffective. With an acceptable rate of complications, it can lead to a satisfactory outcome and an improved functional score.