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Two primary indications call for inserting a needle into a joint: (1) aspiration of fluid for diagnostic purposes or for relieving pressure within a swollen joint and (2) injection of medications. Joint aspiration and intra articular injection are useful and somewhat safe procedures that physicians who treat patients with musculoskeletal conditions can perform readily at the bedside. Clinicians usually can learn and become proficient in aspiration and injection s in a limited amount of time. In appropriate cases, joint injections are a valuable adjunct to medical therapies, rehabilitation, and surgery. In this article, we address the indications and contraindications for joint aspiration and intra articular injection. We also discuss the potential complications, available therapies, technical aspects of injection, and the possible role of guided procedures. Indications and contraindications