Abstract: Objective To analyze MRI features of bucket handle meniscus tears (BHMT) of knee and their diagnostic values. Methods MRI images of 75 cases with meniscus in our hospital from 2015 to 2019 were analyzed retrospectively.Of the 75 cases,25 cases were confirmed to be bucket handle meniscus tear by arthroscopy.Analysis of MRI image features of BHMT included fragment in intercondylar notch sign,double anterior cruciate ligament (ACL) sign,double posterior cruciate ligament (PCL) sign,flipped meniscus sign/double anterior horn,absent bow tie sign,and peripheral residual meniscus sign.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value were calculated,respectively.The diagnostic performance of combination of indicator A (had at least one of the former 4 signs) and indicator B (had at least one of the latter 2 signs) was also evaluated. Results In 25 cases of BHMT,22 cases had absent bow tie sign,23 cases had fragment in intercondylar notch sign,5 cases had double ACL sign,18 cases had double PCL sign,6 cases had flipped meniscus /double anterior horn,and 22 cases had peripheral residual meniscus sign.Among the six signs,the "fragment in intercondylar notch sign" had the highest sensitivity (92.0%),accuracy (90.7%) and negative predictive value (96.2%).Combination of the indicator A and B had greater diagnostic performance with specificity of 98.0%,accuracy of 94.7%,and positive predictive value of 96.2%. Conclusion Bucket handle meniscus tears (BHMT) of knee joint has typical imaging features on MRI.Among them,fragment in intercondylar notch sign is the most basic and reliable sign for the diagnosis of BHMT.