This meta-analysis/systematic review contained 14 randomized or quasi-randomized controlled trials investigating early ankle movement compared to immobilization after ankle fracture surgery. Pooled analysis revealed the effect of early ankle movement on short-term functional outcomes remained unclear compared to immobilization, while no observable difference existed in the longer term. Early ankle movement reduced the risk of postoperative thrombosis/embolism, but was associated with a greater risk of developing deep and superficial surgical site infections, fixation failure, and the need for hardware removal.