Glasgow Rangers confirmed on Thursday that their captain faces up to four months on the sidelines after tests showed he needed surgery to repair ankle ligament damage.
Ferguson underwent an operation to repair the same problem on his right ankle in April 2006 after taking injections to play through pain caused by wear and tear for much of that season.
And the Scotland midfielder endured similar treatment last term after being hindered by what was described as an ankle problem.
Rangers believed Ferguson would be cured by a summer of rest but the 30-year-old suffered an injury to his left ankle in one of the first sessions of pre-season training.
The Ibrox boss told the Scottish Sun: "Barry had the problem with his foot throughout last season and took an injection. But this is totally unrelated.
"He basically went over on his ankle and that was it. He's had it scanned and it turns out he's damaged ligaments—but it's not the problem he had previously.
"I know it was described as his ankle last season, but it was more to do with the base of his foot."