Both magnetic resonance imaging and ultrasonography of the wrist have been advocated for the diagnosis of occult dorsal carpal ganglia. This clinical series compares the utility of the two techniques for confirming clinical suspicion of such occult ganglia. Four wrists in three patients with suspected occult dorsal ganglia were identified prospectively over a 12-month period. Each patient underwent imaging with both techniques on the same day. Subsequently, the wrist was operatively explored and the excised tissue was microscopically evaluated. All wrists in this series had positive magnetic resonance imaging and ultrasound findings, with operative and histologic confirmation of the diagnosis. No diagnostic advantage of one imaging study over the other was identified. With its lower cost and lack of contraindications, ultrasound may be the more suitable technique for establishing the diagnosis of occult dorsal carpal ganglion when clinical findings are inconclusive.