Upper extremity and hand injuries are prevalent in trauma emergency departments, constituting a significant proportion of cases. Among the vast array of injuries, ligamentous injuries of the hand and wrist are frequently encountered, posing diagnostic and therapeutic challenges. Injuries to the thumb’s collateral ligaments, particularly the ulnar collateral ligament (UCL), are common in athletes and individuals participating in activities with repetitive thumb stress. Mechanisms such as hyperabduction and hyperextension frequently result in UCL injuries, clinically known as “skier’s thumb.” Contrarily, radial collateral ligament injuries, although less common, can also lead to significant instability and functional impairment of the thumb. Finger ligament injuries often pose diagnostic challenges due to their asymptomatic nature and complex anatomy. Activities requiring fine motor skills and dexterity predispose individuals to traumatic events, leading to ligamentous injuries. The delicate biomechanics of finger joints and the inherent fragility of ligamentous structures contribute to the susceptibility of finger ligaments to injury. Scapholunate interosseous ligament (SLIL) injuries represent a common cause of wrist instability, with disruptions often leading to abnormal joint functions. Understanding the anatomical features and functional characteristics of the SLIL is crucial for accurate diagnosis and management. Similarly, lunotriquetral ligament injuries contribute to pain and instability on the ulnar side of the wrist, necessitating prompt diagnosis and appropriate management to prevent long-term sequelae. This chapter provides an overview of the epidemiology, pathophysiology, clinical manifestations, and management strategies for ligamentous injuries, focusing on common presentations such as metacarpophalangeal and proximal interphalangeal joint injuries, scapholunate ligament injuries, and lunotriquetral ligament injuries.