Ankle ligament injuries are the most common injuries that occur in sport and recreational activities and account for about 25% of the injuries that occur in running and jumping sports. Depending on the mechanism of injury, ankle sprains can also result in a deltoid ligament injury. The deltoid ligament is primarily responsible for stabilizing the medial side of the ankle anteriorly and posteriorly, limiting talar abduction and hindfoot eversion. Anatomical discrepancies continue to exist, which contributes to a potential for under- or misdiagnosis. Currently, the best diagnostic method for identifying deltoid ligament injuries is MRI, which must be combined with a thorough clinical examination. Injury to both layers of the deltoid ligament results in ankle instability, and this injury is often not diagnosed and consequently not treated properly. This can determine the occurrence of chronic ankle instability. Most often, the deltoid ligament will be treated conservatively or be allowed to heal on its own provided bone stabilization can be obtained. Surgery, however, is useful in cases where the chronic injury results in persistent instability or in acute injuries associated with complex fractures. However, to date, there is no agreement regarding the diagnosis and treatment of deltoid ligament injuries.