Discrimination of normal anatomic landmarks from true disease is one of the fundamental tenets of adept MR imaging. The radiologist is thus compelled to accumulate a comprehensive knowledge of normal structures, variants, and potential MR imaging interpretation pitfalls. In this article the authors focus on a number of normal, bony, ligamentous, and tendinous structures that can simulate disease at the elbow. A discussion of the particular anatomy responsible for the appearance of each of these interpretation pitfalls is provided. In addition, ways to distinguish these pitfalls from true elbow disease are discussed.