Purpose of Review This paper sets out to review the past and current literature on the evaluation and management of the various types of carpal instability. Recent Findings Carpal instability has many sub-types, and therefore, its evaluation and management widely differ. There are recent studies that indicate that while MRI and MR arthrography are the mainstays for evaluation, certain CT and radiographic measurements may be better at diagnosing scapholunate ligament tears. In addition, recent research has proposed multiple sonographic protocols in the evaluation of carpal ligament pathology. However, the comparison of ultrasound to other imaging modalities is limited. The research for operative and non-operative management of carpal instability is limited and often guided by expert opinion. To date, no studies exist on the use of novel injection techniques to treat carpal instability. Summary Evaluation of carpal instability is evolving, and ultrasound may play an increased role. Evidence regarding non-operative management of carpal instability is limited.