Ankle fractures are common among all populations, although incidence increases in the elderly. They are most often the result of simple falls and athletic injuries but also may be caused by underlying pathology. A thorough patient evaluation with description of the mechanism of injury is key to proper diagnosis. This article examines the use of radiography and other imaging modalities in diagnosing ankle injuries, as well as several classification systems available to describe the pattern of injury and aid in treatment planning. Treatment, rehabilitation techniques and possible complications of ankle fractures also are discussed.