This chapter, written for undergraduate medical students and post-graduate doctors in training, presents information on how to manage swollen ankles — a case which they are likely to encounter in the future in a general practice setting. It presents the case of an 88 years old woman who was troubled by swollen ankles. She has definite bilateral oedema, extending up to mid-shins. She has a few fine basal lung crepitations. The chapter provides details of the patients' medical history and the key findings of clinical examination, together with initial investigation results data for evaluation, and helps them develop their skills of clinical reasoning. Key questions then prompt the student to evaluate the patient, and reach a decision regarding their condition and the possible treatment plan.