The objective was to evaluate the functional outcomes of anti-glide fixation by minimally invasive plate osteosynthesis (MIPPO) in lateral malleolus ankle fractures. The study was a retrospective cohort study conducted at a single trauma center. We reviewed 39 patients >60 years old with either isolated or non-isolated lateral malleolus Weber B ankle fractures. The main outcome measures were postoperative functional assessment performed with the American Orthopaedic Foot and Ankle Society (AOFAS) and Short Musculoskeletal Functional Assessment (SMFA) scores. Our results showed that the mean time to surgery was 1 day. Seventeen patients underwent surgery within 24 hours after sustaining the injury. The mean AOFAS and SMFA scores were 87.8 and 209.7, respectively. No patient developed implant failure or wound complications. It was concluded that the anti-glide plating of the lateral malleolus had better functional outcomes compared to lateral plating by open reduction and internal fixation (ORIF), as shown by the higher AOFAS scores and fewer postoperative complications.