ObjectiveTo review the cause, treatment, and prevention of complications of retrograde intramedullary nail fixation for tibiotalocalcaneal arthrodesis and enhance the recognition on the complications of tibiotalocalcaneal arthrodesis. MethodsThe recent literature concerning intramedullary nail fixation for tibiotalocalcaneal arthrodesis was consulted and reviewed. ResultsThere are intraoperative and postoperative complications of intramedullary nail fixation for tibiotalocalcaneal arthrodesis, and the causes, treatment, and prevention of complications are various. ConclusionProgress of retrograde intramedullary nail fixation increases the successful rate of tibiotalocalcaneal arthrodesis. However, there is still a high complication rate, so strict preoperative assessment and skilled surgical technique are necessary to prevent complications.