The radiographic evaluation of congenital and developmental abnormalities of the foot and ankle provides critical information to guide orthopedic treatment. This chapter begins by discussing the anatomy and normal variants of the ankle. Congenital and developmental abnormalities of the ankle are explored, including ball-and-socket ankle. The development and normal variants of the pediatric foot are then discussed. After describing radiographic techniques for imaging the foot, the chapter presents methods to evaluate and vocabulary to describe foot alignment. This is then applied to a broad spectrum of structural deformities of the foot, including clubfoot, cavus deformity, and multiple types of fl atfoot (including tarsal coalition). A discussion of forefoot alignment follows, and the chapter concludes with a brief discussion of congenital foot malformations.In order to provide useful interpretations of foot and ankle radiographs, the radiologist must have a thorough knowledge of the many normal variants that affect this area, recognizing those that may mimic or obscure pathology. Analysis of alignment requires a careful, systematic approach, along with a clear understanding of normal alignment, the wide variety of possible deformities, and the many ways they may combine to create unique constellations of pathology.