Abstract: Objective: To analyze the imaging manifestations of carpal dislocations and fracture-dislocations, to discuss the propagation of forces in wrist. Methods: 129 cases of carpal dislocation underwent the X-ray plain films and the MSCT, analysis of carpal dislocation or fracture-dislocation type. Results: 32 cases of lunate dislocation, 2 cases of central carpal dislocations, 95 cases of perilunate fracture-dislocations: 50 cases of transscaphoid perilunate dislocation, 23 cases of transradial styloid perilunate dislocation, 4 cases of transcapitate perilunate dislocation, 7 cases of transtriquetrum perilunate dislocation,11 cases of transulnar styloid perilunate dislocation. The diagnosis of transscaphoid and transradial styloid were correctly detected on X-ray plain film, the remaining 56 cases with fracture of other carpal bones which X-ray missed 6 cases were usually detected on MSCT and reconstruct technology at last. The pure perilunate dislocation is poor(only 3 cases), there were 5 cases of X-ray diagnosis of pure perilunate dislocation which tiny fracture can be found in MSCT. Conclusion: X-ray plain film may underestimates the full extent of the original injury,accurate and intuitive diagnosis can be made by MSCT. To analyze the propagation of forces in carpal dislocations and fracture-dislocations has an important value for imaging diagnosis.