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The ankle joint is one of the most commonly injured joints and the most common type of fracture to be treated by orthopedic surgeons.[1] The estimated incidence of ankle fractures is approximately 187 per 100,000 people per year.[2] It appears that the incidence of these fractures is increasing in developed countries, presumably secondary to the increasing number of people involved in athletic activity, including physically active elderly patients.[3] Most ankle fractures are malleolar fractures. Approximately 60% to 70% are unimalleolar fractures (predominately lateral malleolus), 15% to 20% bimalleolar, and only 7% to 12% are trimalleolar fractures.[4] The overall incidence is fairly equivalent between sexes, though higher in young males and older females. Due to the fairly common presentation of ankle fractures, knowledge of the proper imaging evaluation of this complex anatomy is important. Though the initial evaluation is with radiography, an understanding of further evaluation with more advanced cross-sectional imaging is also important.