Aim and background: The popularity of ankle arthroscopy is increasing in diagnostic and therapeutic procedures. The surgical technique has evolved over time. Distraction is used for better visualization of the entire joint and ease of instrumentation. Multiple invasive and noninvasive methods have been described. However, a cost-effective and simple setup ideal for a developing country is lacking and needs attention. Technique: The setup consists of a metal stand, generally used for administering intravenous drugs (IV stand), a clamp, and an ankle strap. With the limb on the lithotomy stand, the traction is applied. Using this technique, anterior and posterior portals can be made with ease. Conclusion: This is a convenient and cost-effective setup that can be used for distraction during ankle arthroscopy. The setup comprises equipment commonly found in a hospital setting. Outcomes have been satisfactory among our patients. Clinical significance: A low-cost distraction technique is required in developing countries for good outcomes in ankle arthroscopy. Commercially available distraction setups are expensive. The procedure described provides a good technique that can also be used in a peripheral Indian hospital setting.