The symphysis pubis is demonstrated on many conventional radiographic and cross-sectional examinations and abnormality of the symphysis pubis is a common imaging finding with numerous possible causes. Many significant disorders that affect the symphysis pubis cause it to appear widened, eroded, or destroyed on imaging studies. It is useful for radiologists to have a working differential diagnosis for these appearances, to use when reporting such studies. This review briefly describes the anatomy of the symphysis pubis and presents examples of the various developmental, inflammatory, infectious, neoplastic, traumatic, and metabolic disorders that may cause it to become widened, eroded, or destroyed. Some disorders have pathognomonic imaging features. Others give rise to similar findings that depend more on overall disease activity, rather than the specific diagnosis itself. In such cases, correlation with clinical and laboratory findings will help narrow the differential diagnosis.