Fractures of the carpal bones, excluding the scaphoid, are less common and are often missed on standard, plain radiographs. The diagnosis requires knowledge of the anatomy and common fracture patterns of the bones and the specialized radiographic views necessary to image them. Although the hamate hook, trapezial ridge, and pisiform often fracture from direct trauma, other fractures of the carpus may indicate more widespread injury and require a detailed evaluation to rule out associated perilunate or carpometacarpal fracture-subluxations. Fortunately, if treated appropriately, the vast majority of these fractures heal uneventfully and allow recovery of motion and function of the wrist and hand.