Abstract Background: Variable abnormalities of the tendons of the wrist and hand including injury, inflammation, tumors & anatomical variants used to be evaluated with MRI as a standard modality. Owing to MRI relative limited availability and its high cost, ultrasonography (US) considered a valuable tool in assessment of wrist and hand tendons. Aim of Study: To assess the ultrasonography (US) results in comparison with MRI results which is used as gold standard in assessment of variable wrist and hand tendon abnormalities. Patients and Methods: One hundred patients with different wrist and hand complaints were enrolled in our study, 43 females and 57 males their age between 8-82 years with a median age 45 years. All patients were subjected to history taking and full clinical examination of the wrist and hand. Each patient underwent the ultrasound first before the MRI examination. Results: Near equal results were observed between US findings and MRI findings indicating that we can use both examinations to evaluate the wrist and hand tendons, and that US can be used as initial tool in assessment of the wrist and hand tendon abnormalities. According to our study, sonography exhibited 99% diagnostic accuracy for ganglion cysts, 100% for solid masses of tendon sheath & tendinosis/tenosynovitis, 97% for tendon injury & 98% for anatomical variants of the wrist and hand tendons. Conclusion: Our study demonstrated that ultrasonography and MRI are comparable and closely related as regards detec-tion of different pathological changes in hand and wrist tendons. Further studies are needed to confirm the findings in larger groups of patients and to evaluate the role of Ultra-sonography (US) in assessment of the other structures of the wrist and hand.