Objective To develop a postoperative rehabilitation program using immersive virtual reality (IVR) technology for patients with anterior talofibular ligament injury, and to explore its effectiveness. Methods A total of 76 patients undergoing arthroscopic anterior talofibular ligament repair or reconstruction from March to August 2025 were recruited by convenience sampling and randomly assigned to one of two groups.The control group (n=38) was given routine rehabilitation nursing, while the observation group (n=38) additionally received IVR-based rehabilitation.Pain score, ankle joint function, rehabilitation adherence and quality of life were compared between the two groups before, and at 2, 6 and 12 weeks after the intervention. Results A total of 36 cases in the control group and 37 in the observation group completed the study.Repeated measures ANOVA showed significant group, time, and time-group interaction effects in pain scores, ankle joint function, rehabilitation adherence, and quality of life between the two groups (all P＜0.05). Conclusion Postoperative rehabilitation based on IVR technology can effectively relieve postoperative pain, and improve ankle joint function, rehabilitation adherence and quality of life of patients with anterior talofibular ligament injury.