Forty patients with osteochondritis of the talus were randomized to receive either arthroscopic microfracture combined with radial extracorporeal shockwave therapy (n=20) or arthroscopic microfracture alone (n=20). The primary outcome of interest was the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale score. Secondary outcomes of interest included the Visual Analogue Scale (VAS) score for pain and the area of bone marrow edema of the talus as identified on MRI scans. Outcomes were assessed at six weeks, and three, six, and twelve months postoperatively. Overall, the results of the study revealed that the rESWT group showed significantly better improvement in AOFAS scores and VAS pain scores across all time points, as well as a more significant reduction in the area of bone marrow edema at six and twelve months compared to the control group. These findings suggest that combining arthroscopic microfracture with rESWT may be more effective in managing symptoms and promoting recovery in patients with osteochondritis of the talus.