Background: Ankle pain is a disabling clinical complaint with substantial negative impact on patients' quality of life. The etiology of foot/ankle pain is multifactorial. Despite careful and detailed clinical history and accurate physical examination, reaching an accurate diagnosis is often difficult because nontraumatic ankle pain has a broad-spectrum etiology. Imaging plays a vital role in the etiology of ankle pain. Materials and Methods: This was a prospective study done in collaboration between department of orthopedics and radiodiagnosis and imaging on 43 patients from August 2018 to December 2019. Plain radiography of the ankle joint with anteroposterior and lateral views was done in every patient. Further investigations were advised using the American College of Radiology Appropriateness criteria scale for chronic ankle pain. Results: The most common causes of nontraumatic ankle pain were tendinosis of Achilles 6 (13.9%) including calcific tendinitis, tenosynovitis of other tendons 4 (9.3%), and benign bone tumors 4 (9.3%). Overall imaging was able to pick probable etiology in 34 out of 43 patients. No possible cause could be found in nine cases. Conclusion: Radiological imaging, especially cross-sectional imaging, is an asset for diagnosing etiology of ankle pain. Orthopedicians should not hesitate in referring patients with ankle pain to the radiology department.