Acute injuries that involve the wrist are often secondary to falling on an outstretched hand leading to fractures, sprains, and ligament tears, while those affecting the hand are usually related to a direct impact leading to fractures, dislocations, tendon tears, and ligament tears. Common fractures involve the distal radius, scaphoid, hook of the hamate, and the shaft and neck of the metacarpal bones. Important stabilizing structures like the triangular fibrocartilage complex (TFCC) and the scapholunate ligament are commonly injured and may lead to wrist dysfunction. The ulnar collateral ligament at the thumb, and the flexor and extensor digitorum tendons are also susceptible to acute traumatic injuries in the hand. Typically overuse injuries at the wrist and hand occur secondary to repetitive stress and involve nerve, tendinous, and ligamentous structures. Diagnostic modalities include plain radiographs, ultrasound, and MRI. Some acute traumatic injuries often require early surgical intervention, while most overuse injuries are rehabilitated with therapy and activity modification. The return to sport decision is made after considering multiple factors including tissue healing and a gradual progression of activity tolerance.