Abstract: Objective: The study was to determine the accuracy of MRI for discrimination between tuberculous spondylitis and pyogenic spondylitis.Methods: MR images of 52 patients who had MRI of the spine and confirmed spondylitis were retrospectively reviewed.we compared MRI findings in 20 patients with tuberculous spondylitis and 20 patients with pyogenic spondylitis.Statistical analysis was performed with the chi-square test.Results: The reviewer identified tuberculous spondylitis with sensitivity,（specificity）,and accuracy of 100%（20/20）,80%（16/20）,and 90%（36/40）,and pyogenic spondylitis with sensitivity,specificity,and accuracy of 80%（16/20）,100%（20/20）,and 90%（36/40）,respectively.The patients with tuberculous spondylitis had a significantly higher incidence of MRI findings in many ways than these with pyogenic spondylitis.（Conclusion: MRI） was accurate for differentiation of tuberculous spondylitis from pyogenic spondylitis.MRI;spondylitis;diagnosis,differential;tuberculosis,spinal;suppuration