Abstract Background: Osteoarthritis is a leading cause of disability which has major implications in elderly and public health. Early detection is critical for understanding the disease pro-gression which can contribute in development of new treatment strategies to stop or slow its progression. MRI has excellent soft tissue contrast and advanced techniques have improved its ability to evaluate cartilage morphology and macromolecular changes. Aim of Study: To test the value of adding T2 MERGE sequence to the routine (MRI) protocol of the knee for early detection of cartilage changes around the knee. Patients and Methods: We retrospectively evaluated the images of 107 patients (64 male and 43 female) age ranged between 23-52 years (mean 43.52) who underwent MRI examination of the knee at Menofia University Hospital between June 2019 and February 2020. Results: Our study was a retrospective study done between June 2019 and Feb. 2020 on 107 patients. The patient's age ranged from 23 to 67 years with the mean age 45.6±12.7 years. The study included 64 males and 43 females. There was slight agreement between T2WI and surgical grading (k0/172, p < 0.001), while there was total agreement between 3D merge and surgical grading (k1.00, p < 0.001). 3D MERGE had 100% sensitivity, 100% PPV and 100% overall accuracy compared to Arthroscopic findings. Conclusion: Adding MERGE sequence to the routine protocol of knee MRI has improved sensitivity for detection of early cartilage lesions.