Magnetic resonance imaging is the study of choice in the evaluation of infectious and inflammatory disease of the spinal cord and spinal column. Not only is the multiplanar imaging a distinct advantage over other modalities, but direct visualization of the soft tissues, including the spinal cord, paraspinal musculature, and disk, is present. The sensitivity of MR, to evaluate infectious processes of the spine, especially when used with gadolinium, has been well documented. This article is an overview of the pathophysiology and MR appearance of various types of inflammation and infection of the spine. Subjects covered include disk space infections, epidural abscess, meningitis, arachnoiditis, and inflammatory mimics of disk space infections. Suggested imaging protocols are stated.