MRI has revolutionized the imaging of the spine, providing diagnostic information not available previously with other imaging modalities. Although CT and X-ray plain film still provide better details of the osseous structures and calcifications, these imaging modalities provide little information about the soft tissues that are often the anatomical structures most relevant to a patient’s clinical problem. MRI can provide excellent details of all the anatomical structures of the spine, including the bone, bone marrow, and soft tissues. CT and X-ray plain film remain the preferred choice for initial evaluation of spinal trauma, but for most other spine diseases, MRI has become the preferred imaging modality. Spine diseases that are best evaluated with MRI include degenerative spine disease, spine infection, and neoplasm. In addition, MRI is often required for evaluation of acute traumatic spine injury, particularly when injury to the spinal cord, ligaments or vascular structures is suspected.