Objective To investigate the clinical characteristics and treatment of asymmetric syndesmosis. Methods The clinical data of 2 cases of asymmetric syndesmosis admitted to our hospital in recent 10 years were introduced, and the relevant literature was analyzed and summarized. Results The diagnosis of asymmetric syndesmosis was clear in 2 cases. After multidisciplinary consultation, a detailed surgical plan was drawn up. All patients underwent asymmetric syndesmosis under general anesthesia, and multidisciplinary treatment was continued after operation. Follow-up after discharge showed that the patients grew well without obvious complications and adverse signs. Conclusion Asymmetric syndesmosis is rare in clinic. At present, the only treatment is surgical excision. Before operation, the local anatomy of the children"s syndesmosis can be fully assessed by imaging related examinations, and a perfect surgical plan can be drawn up. The operation should be careful during the operation, and the treatment plan can be worked out by multi-disciplinary cooperation after the operation. Long-term follow-up is needed after discharge.