Injuries of the midfoot comprise fractures, dislocations and/or fracture-dislocations of the Chopart and Lisfranc joint lines. Fracture-dislocations, in particular, represent prognostically severe lesions which may compromise foot function to a high degree. A substantial number of injuries of the midfoot (about one-fourth!) are still primarily overlooked. As such, a diagnostic algorithm is essential for the adequate detection of the injury components and planning of the therapeutic approach. Standard X-rays in three planes (dorso- plantar, lateral and lateral oblique view) represent the diagnostic basis which is supplemented by CT scanning and multiplanar reconstructions, in particular, in cases where a potential midfoot lesion is suspected. MRI may be helpful in mainly ligamentous injuries, only. The principle strategy of treatment includes anatomical reconstruction of the joint structures, the geometric proportions of the medial and lateral foot columns and the diagnostics and treatment of ligamentous instabilities. If these goals can not be achieved or in case of complications further interventions as corrective osteotomies and limited arthrodeses of the midfoot are unavoidable.