This study assessed the effect of litigation on the long-term outcome and recovery of ankle inversion injuries. 167 patients from an accident and emergency database were contacted by telephone. Thirty participants were litigating and these candidates were randomly matched with 30 non-litigating patients with respect to mechanism of injury. Each group had 27 patients with ankle sprains because of falls/trips and 3 after road traffic accidents. Radiographs when available of each participant were examined and the degree of soft tissue swelling over the lateral malleolus was assessed. 76.6% of litigants reported incomplete recovery compared to 26.7% of non-litigants. The median period of sleep disturbance, swelling, limping and non-weight-bearing was 1.5 days, 2.0 weeks, 2.0 weeks and 1.0 weeks for the non-litigants. This compares to 3.5 days, 10.0 weeks, 8.0 weeks and 8.0 weeks for the litigants using the same variables (p<
0.0001 in all cases). Where ankle radiographs had been taken swelling was equal in each group (9.0mm over lateral malleolus (30% of litigants incorrectly suggested an ankle x-ray had been taken, when it had not)). The majority of litigants (65%) thought that physiotherapy would not be beneficial in rehabilitating their ankle (35% non-litigants) It appears that litigation has a negative effect on the outcome and recovery of ankle sprains.