BACKGROUNDGlobal developmental delay can be defined as a significant impediment in two or more developmental domains. Magnetic Resonance Imaging (MRI) is one of the best modalities for evaluation of such patients. Making a correct diagnosis is one of the most essential steps in the prevention of childhood neurological disease. Early diagnosis is essential for parental counseling and treatment. METHODSThis is an observational and prospective study of MRI Brain (and spine if associated with spinal dysraphism) in 146 paediatric patients (85 males, 61 females) referred to Department of Radiodiagnosis, SNMC, Agra, presenting with developmental delay, over a period of 22 months ( Jan 2017-Oct 2018). MRI Brain was done on 1.5 T Phillips Achieva with appropriate sequences and planes after making the child sleep/sedated/anaesthetized. Various anatomical structures like ventricles, corpus callosum, etc., were systematically assessed. The MRI findings were divided into various aetiological subgroups. RESULTSNormal MRI findings were seen in 30.1% of cases and 69.9% had abnormal findings of which the proportion of traumatic/neurovascular diseases, congenital and developmental, metabolic and degenerative, neoplastic and non-specific were 31.5%, 18.5%, 3.4%, 4.8% and 11.6% respectively. The white matter, mainly the periventricular white matter and corpus callosum, and the ventricles were found to be the most commonly affected structures. CONCLUSIONSMRI is an important part of the complete evaluation of children with developmental delay as many aetiological conditions can have a better prognosis, if diagnosed early.