Background. Early detection and treatment of Lisfranc injuries in the athletic population is paramount for successful return to sport as well as outcome. The present study evaluates surgical interventions for these types of injuries as well as return to activity (RTA), function and post-operative degenerative joint disease. Methods. The data from nineteen patients prospectively followed from 2008 through 2016 presented. Of these patients, six (31.6%) were treated with suture-button fixation, seven (36.8%) with metallic screws and plates and six (31.6%) with bioabsorbable screws. The average RTA was 24.0 ± 10.3 weeks. The post-operative Roles and Maudsley (RM) score was 1.2 ± 0.4. 21% of the patients were noted to have joint space narrowing at the final post-operative x-ray. Hardware removal was performed in six (31.6%) patients. Results. All of the patients were able to return to their sporting activities. Conclusions. Based on the current study, anatomic reduction showed to be the highest predictor of surgical outcome, regardless of fixation technique, consistent with previous studies. ORIF of Lisfranc injuries in the athletic population provides safe and predictable results with good medium-term outcomes.