For decades, the determination of bone maturity has relied on a visual evaluation of skeletal development in the hand and wrist, most commonly using the Greulich and Pyle atlas. The Gilsanz and Ratib digital atlas takes advantage of the advent of digital imaging and provides a more effective and objective approach to skeletal maturity assessment. This atlas integrates the key morphological features of ossification in the bones of the hand and wrist and provides idealized, sex- and age-specific images of skeletal development. This computer-generated set of images should serve as a reasonable alternative to the reference books currently available.