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Background: Task-oriented training on an unstable support surface is an effective intervention for improving the ankle joint stability and muscle strength in patients with ankle instability. This study examined the effects of balance training on an unstable support surface in patients with ankle sprains with ankle instability. Methods: Forty-four patients with ankle sprains participated in this study. Screening tests were performed and assigned to an experimental group, who performed task-oriented training on an unstable support surface (n=22), and a control group, who performed task-oriented training on a support surface (n=22) using a randomization program. All interventions were applied 3 times per week for 4 weeks. The numeric rating scale (NRS), cumberland ankle instability tool (CAIT), balance ability, muscle activity, and muscle thickness were compared to evaluate the effects of the intervention. Results: Both groups showed significant differences in the NRS, CAIT, balance ability, and muscle activity between before and after the intervention (p<.05). In addition, there were significant differences in balance ability, muscle activity, and muscle thickness between the experimental and control groups (p<.05). Conclusion: Task-oriented training on an unstable support surface is an effective intervention for improving the balance ability, muscle activity, and muscle thickness during contraction.