Ankle pain is a common complaint in orthopedic practice. Various imaging techniques are available for assessment of ankle joint abnormalities. However, many ankle injuries were undiagnosed by conventional radiology and needs further evaluation to diagnose ligamentous, tendinous and muscle injuries as well as osseous lesions as stress fractures, osteochondral lesions, and avascular necrosis. The aim of this study was to compare the diagnostic accuracy of both ultrasonography (US) and magnetic resonance imaging (MRI) for the assessment of pain around the ankle in musculoskeletal disorders. Ultrasonography was 100 % sensitive in detecting tendinous and ligamentous injuries, ankle effusion, synovitis, bursitis, ganglion cysts, lipoma, and vascular dilatations. Ultrasound had no rule in detection of intrinsic osseous lesions, and other non-accessible lesions such as unseparated talar dome osteochondral injuries.