167 patients scheduled for orthopaedic forefoot surgery were randomized to regional anesthesia with either an ankle block or a popliteal fossa block. Patients were assessed for the rate of conversion to general anesthesia due to inadequate block, as well as pain and patient-reported effectiveness over the first 2 days postoperatively. Overall, the rate of conversion to general anesthesia did not significantly differ between groups. The ankle block group demonstrated significantly greater opioid consumption for the remainder of the day of surgery and greater pain scores until noon of the first postoperative day when compared to the popliteal fossa block group. Thereafter, groups did not significantly differ.