The influence of the timing of surgery for closed ankle fractures on complications is unclear. Previous studies have failed to demonstrate any associations with clear statistical support. This is a retrospective review of 221 patients presenting with closed ankle fractures treated with open reduction and internal fixation. The patients were similar in respect to age, gender, fracture type, surgeon grade, American Society of Anaesthesiologists grade, grade of anaesthetist and tourniquet time. Power analysis was performed for sample size. Patients were followed up until fracture union. The mean duration of inpatient care was greater in the delayed group (p = 0.0002). There was an increased rate of local (p = 0.0451) and total complications (p = 0.0116) if surgery was delayed more than 24 hours. This observational study demonstrates that for the management of closed ankle fractures there is an adverse clinical outcome in patients who undergo delayed operative intervention.