Osteoid osteoma is a benign tumor of the bones. The adolescent males are the most commonly involved population. Pain of the affected site forms the common symptom during clinical presentation. The lower limbs are the most commonly affected site.We present here a case report of a middle aged gentleman who presented to us with complaints of pain and mass over the non-dominant ankle for four years. Clinical examination revealed a bony hard swelling proximal to the lateral malleolus. The radiographs and CT scan reports were consistent with features suggestive of an exostosis bridging the distal tibio-fibular syndesmosis. Surgical exploration revealed a mass with definite borders bridging the distal tibio-fibular syndesmosis. Excision biopsy was performed and the histopathology of the specimen reported features consistent with that of an osteoid osteoma. The patient was started on physiotherapy of the ankle and he was noted to have full range of ankle motion at six months. As no such case has been reported in earlier in literature we present it as a rare case report.

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