Objective To investigate the diagnostic value of MR imaging in cervical spinal canal stenosis combined with spinal cord injury. Methods From August 1998 to May 2008, 41 patients with cervical spinal canal stenosis and spinal cord injury were treated, including 34 males and 7 females aged 32-71 years (average 53.4 years, 27 patients being older than 60 years). Patients’ MRI data were retrospectively analyzed. Injury was caused by fall ing from height in 8 cases, traffic accidentin 19 cases, crush due to heavy objects in 3 cases and other reasons in 11 cases. The time from injury to operation ranged from 2 hours to 3 years. There were 12 cases of anterior spinal cord injury syndrome, 23 of central spinal cord syndrome and 6 of Brown-Sequard syndrome. JOA score of spinal cord function was 3-11 points (average 6.6 points). Results MR imaging diagnosis before operation showed abnormal signal changes within the spinal cord in 37 cases (41 sites), anterior and posterior longitudinal l igaments and discs (APLLD) injury in 28 cases (30 sites) and signal of edema and hematoma signals in anterior surface of cervical spines (EBC) in 34 cases (36 sites). Diagnosis during operation revealed edemas braises, contusions tears of posterior soft tissue in 18 cases (20 sites), appendix fracture in 6 cases (7 sites), formation of EBC in 20 cases (23 sites), APLLD injury in 34 cases (44 sites), intervertebral instabil ity without the rupture of l igament and intervertebral disc in 7 cases (10 sites). Significant difference was evident between the MRI diagnosis before operation and the intraoperative discoveries (P lt; 0.05). Conclusion The MR imaging diagnosis before operation do not correspond to the intraoperative discoveries, indicating that MRI diagnosis fails to make a relatively comprehensive and accurate diagnosis. So it is advisable to make a diagnosis based on cl inical symptoms.