Carpal fracture-dislocations of the wrist are rare, high-energy injuries with high morbidity rate. If we leave aside the axial carpal fracture-dislocations, delayed diagnosis is a common case in perilunate fracture-dislocations. Early and accurate diagnosis is essential to minimize morbidity. In some cases of perilunate fracture-dislocations, good results have been reported with early closed reduction. But for good functional results, internal fixation and ligament repair may be required. Surgery is performed by combined volar and dorsal approaches. Axial fracture-dislocations may be associated with injuries of the soft tissues, tendons and nerves. The repair of these associated injuries with anatomic reduction and fixation of the fracture-dislocation is also important. In this article, after a brief review of anatomical classification, we focus on the etiopathogenesis, diagnosis, and treatment of carpal fracture-dislocations and the results.