Abstract Background: Developmental delay is defined as significant delay in one or more developmental domains. Aim of Study: To evaluate prevalence of normal and abnormal MRI brain in children presenting with developmental delay. Material and Methods: It is a prospective & descriptive study of MRI Brain in 65 paediatric patients (34 males and 31 females), aged between three months to 18 years; presenting with developmental delay referred to Metabolic and Neurology Units at Abo El-Resh Hospital over a period of one year (May 2018 to May 2019). Clinical evaluation was performed by paediatric neurologist. MRI brain was done with appropriate sequences. Results: The proportions of children having abnormal MRI findings in our study yield of 82%. Most of them were in age group of three to 12 months (26%). Males (51%) were slightly more in number than females (49%). Metabolic and degenerative disorders represent 41.5% of abnormal MR findings, congenital and developmental anomalies (26.2%), non-specific findings (7.7%), infection (4.6%) and tumours (1.5%). The most common category of metabolic disorders was lysosomal storage diseases. Congenital and developmental disorders were more common in males. The ventricles and white matter mainly the corpus callosum were the most commonly affected anatomical structures. The highest diag-nostic yield was seen in patients presenting with developmental delay plus. Conclusion: MRI can easily detect many specific aetiologic and pathophysiologic conditions, which will greatly help the clinician for proper diagnosis, treatment and counselling of the parents.