AbstractBackground: Chronic ankle pain is considered a diagnosticchallenge because of variable causes including traumatic andnon-traumatic causes. MRI is considered an excellent methodof diagnosis of soft tissue abnormalities around ankle joint.Ultrasonography also can detect normal anatomic structureand assess ligamentous abnormalities, and provide dynamicevaluation of the soft tissues. Ultrasonography is more avail-able, cheap, fast, and safe method of diagnosis.Aim of Study: Was toevaluate the accuracy of both ultra-sonography and magnetic resonance imaging in diagnosis ofdifferent causes of chronic ankle pain.Patients and Methods: A comparative study conductedupon attendants referred from orthopedics clinic who com-plained of ankle pain.Results: In this study ultrasound successfully diagnosedand characterized 35 out of 40 patients (85%) while MRIdiagnosed and characterized 36 patients (87.5%). MRI is themodality of choice for optimal detection of most of osseousand; soft-tissue disorders of ankle with higher axial resolutionand multiplanar capabilities while ultrasound proved to beexcellent cost-benefit widely available imaging technique thathas high spatial resolution making it helpful tool in diagnosingmost of ankle soft tissue disorders with high diagnosticaccuracies almost equal to MRI values.Conclusion: Ultrasonography and MRI are two methodsof investigations with the former being used as primary toolof investigation and the latter done to confirm diagnosis andthe extent of the lesion especially when surgery is planned.