Management of Lisfranc injuries has evoked significant debate and controversy over the years, and there is no indication that the controversy is nearing an end. Probably the main reason for the controversy is because a "Lisfranc injury" is part of a very wide and poorly defined spectrum of injuries. Not all Lisfranc injuries are created equal, and there will never be a single treatment option for all these injuries. Lisfranc injuries are relatively uncommon, but if undetected, untreated or under-treated can cause morbidity and disability. The objective of this article is to provide guidelines for treatment of the spectrum of Lisfranc injuries.