Although conventional radiographs continue to be used as a primary method for the diagnosis of stress fractures, the limitations of radiography in early detection have been increasingly recognized. Advanced imaging techniques, including radionuclide methods, and more recently, MR imaging, have increasingly been employed in the assessment of stress fractures, and have provided valuable insights into the spectrum of stress-related changes to bone. This article reviews the diagnostic methods available to the clinician for detection of stress injuries to bone.