〔Abstract〕 ObjectiveTo compare the diagnostic value of X-ray plain film, computed tomography (CT) and magnetic resonance imaging (MRI) in ankle joint sports injury. Methods A total of 120 patients suspected of ankle joint sports injury treated in Xuzhou Tongshan District Hospital of Traditional Chinese Medicine from August 2019 to August 2022 were selected as the research objects. X-ray plain film, CT examination and MRI examination were performed to compare the diagnostic effects of the three examination methods. Results The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of MRI examination were higher than those of X-ray plain film and CT examination, and all the indicators of CT examination were higher than those of X-ray plain film, the differences were statistically significant (P < 0.05). The consistency between CT examination and MRI examination diagnosis results and clinical final diagnosis were high (κ = 0.742, 0.893, P < 0.05), while the consistency between the X-ray plain film diagnosis results and clinical final diagnosis were moderate (κ = 0.521, P < 0.05). For ligament tendon injury and articular cartilage injury, the detection rate of MRI was significantly higher than that of CT and X-ray plain film, the differences were statistically significant (P < 0.05), but there was no statistical significance between CT and plain X-ray film (P > 0.05). In terms of fracture detection rate, CT was higher than MRI and plain X-ray, the differences were statistically significant (P < 0.05), but there was no statistically significant difference between MRI and X-ray plain film (P > 0.05). Conclusion For ligament tendon injury and articular cartilage injury, MRI examination has significant advantages, and CT is superior to MRI and X-ray plain film in the diagnosis of fracture.