Background: Diagnosis of spinal tuberculosis is a major challenge. It is usually made using a blend of, laboratory , imaging investigations, clinical and none of these are 100% confirmatory. The objective of this study was to determine the diagnostic accuracy of magnetic resonance imaging (MRI) for detection of spinal tuberculosis (TB) Methodology: This cross-sectional study was conducted in the department of Radiology, Lahore General Hospital, on 150 patients, with suspicion of spinal TB from January,2020 to August,2020.  Patients having Backache for >6 months, loss of appetite, loss of weight >10% in previous one month, raised ESR >15 mm/hour, and positive sputum results for AFB were included. The patients underwent full spinal MRI scan. MRI was done using 1.5 Tesla MR for diagnosis of spinal TB. The diagnosis of spinal TB was then confirmed on histopathologic reporting. Results:Mean age of study participants was 47.83±9.65 years. There was male predominance with 93 (62.0%) males and 57 (38.0%) female patients. The mean duration of spinal TB symptoms was 11.52±3.12 months. On accuracy of MRI, there were 83 (55.3%) true positive cases, 10 (6.67%) false positive, 08 (5.33%) false negative and 49 (32.67%) true negative. The sensitivity of MRI was 91.2%, specificity 83.1%, positive predictive value (PPV) 89.2% and negative predictive value (NPV) 86.0%. Conclusion: Sensitivity of MRI was 91.2% and specificity 83.1%.MRI is an ideal non-invasive imaging modality for the diagnosis of spinal TB. Keywords: Magnetic resonance imaging, Spinal, Tuberculosis.