Background: Injuries to the foot and ankle are often missed or underestimated during the initial care for poly-traumatized patients. Aim: to evaluate the role of MDCT in evaluation of osseous injuries of the ankle. Methods: The present work included sixty even patients, All patients were recommended for CT evaluation after being examined by a plain X-ray to further evaluate already diagnosed, or exclude ankle and hind foot osseous injuries. All patients were examined using 6 and 16 multi-detector CT scanners. Results: The present study included 20 malleolar , 18 Pilon fractures, 15 talar fractures, and 23 calcaneal fractures. Six patients (9%) had multiple fractures of the ankle region . Of which five patients (7.5%) had Pilon and talar fractures, and one patient (1.5%) had calcaneal and malleolar fractures. MDCT allows for scanning through full plaster casts or back-slabs. eighteen patients constituting 23.7% presented with distal tibial fracture (Pilon fracture). Conclusion: Computed tomography is valuable in the diagnosis of cases of occult syndesmotic injury, especially when the patient cannot tolerate stress radiographs. MDCT is recommended if an intra-articular fracture or major displacement is suspected. This allows for a three-dimensional analysis of fracture morphology and determination of joint involvement and is extremely helpful in planning the surgical approach.