The lack of radiation, high soft tissue contrast and capacity for multiplanar and three-dimensional imaging have made magnetic resonance imaging (MRI) the imaging modality of choice for evaluating spinal cord diseases. In diagnostic imaging of the spine, MRI is clearly superior to both conventional radiography (CR) and computed tomography (CT) and it should be preferred as first diagnostic examination when degenerative spine pathologies are suspected.The other technological equipments (CT, CR, dynamic orthostatic X-ray, myelography, discography and skeletal scintigraphy) have to be selectively chosen and adapted to the individual patient.Both "container" and "contents" of the spine should be primly evaluated. Finally, a correlation between clinical and radiological features seems to be mandatory for selecting the correct therapeutic choice, since the reliability of the MRI as potential prognostic indicator has been demonstrated.