Pelvis and hip trauma has a bimodal distribution, occurring most commonly due to high-energy trauma in young patients and as low-energy fragility fractures in the elderly. Radiography is usually adequate for assessing acute hip trauma, although MRI or CT should be considered to evaluate for occult femoral neck fractures in patients with a high index of suspicion for injury. CT is usually required for assessment of pelvic fractures due to the complex bony anatomy osteology of the pelvis. Intravenous contrast is not needed to assess for fractures on CT but should be used in high-energy trauma to characterize soft tissue injuries. MRI is the best modality for identifying most soft tissue injuries; however, it is rarely utilized in the acute trauma setting because musculoskeletal soft tissue injuries rarely require urgent management. Avulsion fractures are common in pelvis and hip trauma. It is important to be familiar to attachment sites of major muscle groups in order to identify these injuries. Pathologic fractures of the hip are also common. Particularly, low-energy fractures of the subtrochanteric femur or avulsion of the lesser trochanter in adults should be considered highly suspicious for an underlying osseous malignancy focus and should undergo further imaging and clinical evaluation.