Magnetic resonance imaging (MRI) has become accepted as the most sensitive imaging modality for the study of spine pathology. MRI has several major advantages over other imaging modalities that often make it the most sensitive diagnostic tool for common spine pathology. MRI does not use high-energy ionizing radiation like its counterparts, computed tomography (CT) and X-rays, which are associated with long-term cancer risks. Plain films or CT may be able to visualize bone fractures or dislocations in trauma patients, but are unable to detect associated traumatic disc herniations and occult ligamentous injuries that can only be picked up by MRI. MRI is also the best modality to detect early infection and to evaluate the full extent of potentially life-threatening lesions affecting the spine, such as osteomyelitis, discitis, epidural abscess, and myelitis. MR safety continues to evolve with the proliferation of more sophisticated implant and monitoring devices.