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Subtalar arthroereisis (STA) is a surgical option in the treatment of flatfoot with the aim of re-establishing a medial foot arch and limiting the motion of the subtalar joint without blocking it. We performed a critical review of the scientific literature in order to define the role of arthroereisis in the treatment of flatfoot based on recent evidence provided, thus resuming the current state of understanding and highlighting the areas where knowledge was still lacking. Secondly, in a retrospective clinical study, we assessed a cohort of patients treated as children hypothesizing that (1) STA provided significant radiographic correction of low longitudinal arch and forefoot abduction in paediatric flatfoot (FF) and that (2) mid-term clinical outcomes were satisfactory and comparable to a normal population. Thirdly, we investigated STA as an adjunct procedure to medialising calcaneal osteotomy, flexor digitorum longus tendon transfer and spring ligament repair in a comparative study on the adult population. As demonstrated in our results, while STA seems to mechanically contribute to the morphological correction of flexible flatfoot providing good clinical outcomes, the risk of complications (especially persistent pain) and the need of removal of the implant must be considered and discussed at length during the preoperative counselling.