The diagnostic performance of magnetic resonance (MR) imaging in the evaluation of the triangular fibrocartilage complex and the intrinsic and extrinsic ligaments of the wrist was assessed in 43 patients with chronic wrist pain. Forty-one patients underwent correlative arthrography. Twenty-three patients underwent arthroscopy or arthrotomy or both. The normal anatomy of the triangular fibrocartilage and the intrinsic and extrinsic ligaments could be demonstrated effectively with MR imaging. MR imaging was effective in the evaluation of triangular fibrocartilage tears with a sensitivity of 1.0, a specificity of 0.93, and an accuracy of 0.95 when compared with arthrography; 0.89, 0.92, and 0.90, respectively, when compared with arthroscopy and arthrotomy. MR imaging could also be used effectively to evaluate tears of the intercarpal ligaments, particularly the scapholunate ligament. Disruptions of the extrinsic ligaments, articular cartilage defects, and subluxations of the distal radioulnar joint were also well demonstrated. MR imaging is an effective procedure in assessing patients with chronic wrist pain.