Ulnar sided wrist pain is frequently following a distal radius fracture. Of the patients with a Colles fracture 35% will develop ulnar sided wrist pain. The anatomy of the ulnar side of the distal forearm is complex and consists of the distal radioulnar joint, the distal ulna and the triangular fibrocartilagenous complex. Based on the anatomy, ulnar sided wrist pain can be divided into osseous, ligamentous, tendinous, neurological or vascular pathology. Thorough history taking, physical examination with additional specific tests and imaging support the diagnosis. Arthroscopy of the wrist is considered to be the gold standard in diagnosing ligamentous injuries and osteoarthritis of the radiocarpal joint. Considering the association of ulnar sided pain with distal radius fractures and accompanied soft tissue injuries, we advocate a multidisciplinary approach to this condition.