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Abstract Background: The uterine pathologies constitute one of the most common problems among women. The most common of them are adenomyosis, uterine leiomyoma, carcinoma of uterus and cervix and endometrial pathologies including polyp and hyperplasia. Aim of the work: to compare the role of (MRI) and (trans abdominal & trans vaginal) in assessment of uterine masses. PATIENTS AND METHODS This prospective study was performed on 25 female patients with suspected uterine lesions. They were referred from the Gynecology Department to the Radiology Department of Ain Shams University Hospital to perform pelvic MRI study in period between from June 2019 till April 2021. Results: Ultrasonography among the studied cases detected that Endometrial hyperplasia was the most frequent finding (32.0%), followed by myoma (28.0%), adenomyosis (16.0%), polyp (12.0%), carcinoma (8.0%) and (4.0%) without detected abnormality. However, MR evaluation among the studied cases detected that myoma was the most frequent finding (28.0%), followed, adenomyosis (24.0%), polyp (5.0%), endometrial hyperplasia (16.0%) and carcinoma (12.0%). Hence, our results revealed that there was statistically significant perfect agreement between MRI evaluation and final diagnosis by hysteroscopy and histopathology regarding overall diagnosis of uterine lesions (p value<0.001). Consequently, our study revealed that MR had sensitivity and specificity of 100% for diagnosis of all uterine lesions (uterine myomas, adenomyosis, polyp, hyperplasia and carcinoma). Conclusion: MRI has a sensitivity of 100% with a superior |