Hand infections, whether acute or chronic, require prompt diagnosis and management to prevent complications like stiffness, contractures, or amputation. While most infections of the hand and wrist are confined to superficial soft tissues, deep infections such as necrotizing fasciitis, osteomyelitis, and septic arthritis often require surgical intervention. Imaging is crucial for assessing the infection extent, particularly in cases with suspected bone or joint involvement or deep abscesses, guiding treatment, and distinguishing infections from inflammatory arthritis or tumors. Radiographs are the first-line imaging tool and can be used for monitoring osteomyelitis, with changes appearing 8–10 days post-infection. Magnetic resonance imaging (MRI) is the gold standard for detecting and staging infections, with gadolinium-enhanced imaging aiding in detecting abscesses. Computed tomography (CT) is particularly useful in chronic osteomyelitis for detecting sequestra requiring surgical removal, while ultrasound (US) imaging effectively detects fluid collections, abscesses, and foreign bodies. Chronic infections should be considered in patients presenting with painless swelling or draining sinuses. Comprehensive clinical evaluation, along with pathogen identification through imaging-guided aspiration, is crucial for targeted antibiotic therapy. A multidisciplinary approach, involving radiologists, infectious disease specialists, and hand surgeons, is essential for optimizing treatment and minimizing morbidity.