Falls on the outstretched hand, with resultant pain in the carpal region, account for a significant number of referrals to emergency rooms worldwide. Not only do they represent a significant proportion of the radiological workload arising from emergency rooms, interpretation of the images acquired is often difficult due to the complex anatomy of this region, compounded by an inability to obtain adequate views due to patient discomfort. Often, despite apparently normal radiological examinations, patient discomfort persists, prompting a need for further imaging. It is vital that the radiologist be entirely familiar with the bony and ligamentous anatomy of this body region, as well as possess an understanding of the frequent mechanisms of injury. Using a variety of imaging techniques, we illustrate a spectrum of carpal injuries, common and otherwise, explaining the mechanism and typical appearances of each.