Lisfranc injuries, which affect the tarsometatarsal joint and are relatively rare, have a 20% misdiagnosis rate. This can result in serious complications such as foot instability, degeneration, or chronic pain. Due to the absence of clear diagnostic guidelines, this article reviews existing literature and research to propose an algorithm for identifying potential Lisfranc injuries. The literature review summarizes information on diagnostic methods for Lisfranc complex injuries. It was executed using PubMed, Web of Science, and Google Scholar databases. Scientific publications published between 2016 and 2024 were counted in review and scientific before this period. Lisfranc complex injuries, especially subtle cases, are frequently missed due to both patient oversight and physician error. In diagnostic trials, tools like traditional X-rays or CT scans are commonly employed, however MRIs and ultrasounds are often overlooked. Weight-bearing X-rays and weight-bearing CT could be promising due to their high sensitivity. Appropriate patient interview and physical examination along with imaging are essential points for making an accurate diagnosis. It is important to diagnose Lisfranc injuries to prevent the development of serious complications. Greater patient awareness and a comprehensive diagnostic approach by doctors are key to improving detection rates. Subtle Lisfranc injuries are the greatest diagnostic challenge. Weight-bearing CT scans and radiographs could be very helpful in identifying these injuries. Further research is needed to optimize the use of these imaging methods.