Joint replacement procedures have improved dramatically during the past 30 years fueled by the changes in techniques for hips and knees. Joint replacements in other anatomic regions also have become more popular. It is essential to understand the importance of pre- and postoperative imaging for evaluating patients. Preoperative images are used in concert with clinical data to select the appropriate patients and components. Postoperative imaging is critical for evaluating position and potential complications. Appropriate selection of imaging modalities is essential to provide optimal, cost-effective patient care.