A tarsal coalition occurs in approximately 1% of the population and often is an overlooked diagnosis when it presents in adults. Zuckerkand published the initial description of a talocalcaneal coalition in Germany in 1877. Anderson reported the presence of talonavicular coalitions in 1879, and Slomann introduced the 45-degree lateral oblique view of the foot to diagnose calcaneonavicular coalitions in 1921. Slomann also suggested the presence of an association between pes planus, hindfoot rigidity, and tarsal coalition. Badgley associated calcaneonavicular coalition with peroneal spastic flatfoot in 1927. Later, Harris and Beath linked peroneal spastic flatfoot with talocalcaneal coalition. Advancements in multiaxial imaging have enhanced our understanding of tarsal coalitions. Modern CT and MRI enable surgeons to characterize the extent of joint involvement, the composition and location of the coalition, and the degree of degenerative change of the affected and adjacent joints. This new information has influenced our clinical decision-making and treatment of tarsal coalitions. The purpose of this review is to discuss evidence-based recommendations for diagnosis, imaging, and treatment of tarsal coalitions in the pediatric and adult populations.