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Osteochondritis dissecans (OCD) of the talus is rare in children. The lesion is encountered on either the medial or lateral surface of the talar dome. The etiology is unknown, although trauma has been implicated, particularly in lateral lesions. Since 1983, 24 children have been treated for OCD of the talus at a major Canadian pediatric referral center. Two children had bilateral involvement, for a total of 26 lesions. There were 10 boys and 14 girls. The average age at initial presentation was 13 years 4 months (range 6 years 7 months to 17 years 1 month). The lesion involved the medial aspect of the talus in 19, the lateral in 5, and the central talar dome in 3. Magnetic resonance imaging was very useful in preoperative assessment in six cases. Surgical intervention was required in 15 (58%) ankles. The results at the most recent follow-up revealed resolution or decreased symptoms in 25 (96%) and no change in 1 (4%).