MR imaging is widely used in the evaluation of internal derangement of joints. In the past, the use of hand and wrist MR imaging lagged behind imaging of larger joints, largely because of technical limitations of spatial resolution and signal-to-noise ratio when imaging the small anatomic structures. However, with recent technical advances in extremity coil design, MR imaging has provided us with new insights into the difficult anatomy of the wrist by allowing improved visualization of the relationship of the muscles, ligaments, tendons, and bone. Although the limits of spatial resolution afforded by specialized surface coils and signal processing methods may not have yet been completely realized at 1.5 Tesla, the potential for significant improvements in hand and wrist imaging is likely to rest with the advent of higher strength magnets.