Shoulder pain is a common clinical problem. Although its causes are multiple, its clinical symptoms and signs can frequently overlap. To plan the most effective means of therapy, an accurate diagnosis must be made.Radiographic evaluation is an important and necessary adjunct to the clinical examination in patients with shoulder pain. Noninvasive imaging modalities, including plain radiography, radionuclide studies, tomography, and computed tomography (CT), often reveal nonspecific findings. Invasive examinations such as arthrography1,2and conventional and computed arthrotomography3–6may yield a more specific diagnosis but are not without morbidity.7Ultrasound has been reported to be a useful technique in the evaluation of the shoulder for rotator cuff abnormalities.8but it is limited in the scope of diseases it can assess and is highly dependent on the experience of the examiner.Recent technical advances have resulted in significant improvement in the ability to obtain diagnostic images of the shoulder with magnetic resonance imaging (MRI). These include off-center field of view and oblique imaging,9,10as well as improvements in surface coils.We have used MRI in a large number of patients with shoulder pain. MRI has been effective in the noninvasive diagnosis of many shoulder disorders, particularly those that result from rotator cuff disease. It may replace most of the other techniques used to evaluate the shoulder. This article will review current experience with this modality and discuss relevant technical, anatomic, and pathologic issues.