Background: Cerebral palsy (CP) is the most common cause of physical disability in childhood with prevalence rates of 2–3 per 1000 live births in developed countries. CP is the leading cause of physical disability in children. Thus, neuroimaging is currently recommended as a standard evaluation in children with cerebral palsy. Objective: To investigate the relationship and inter-relation between functional profiles including; gross motor function and manual ability, with brain magnetic resonance imaging characteristics in children with CP before and at end of functionally based exercise program. Patients and Methods: This study was carried out on twenty five spastic CP children of both genders at age ranged from 3 months old to 12 years old, attending the out-patient pediatric clinic of Bab Al Sha'reya University Hospital, during the period from May 2019 to December 2019. Results: Diplegia was the most common represented type, followed by quadriplegia and hemiplegia. The common causes were hypoxic ischemic encephalopathy (52%), Post-kernicterus CP (32%), and Post traumatic CP (16%). History of mother drug intake, hypoxia, pre-mature birth, cyanosis and severe RDS, delivery with caesarian section, neonatal convulsion, jaundice and post-kernicterus complication, and head trauma were significantly associated with increased risk of CP. Conclusion: History of mother drug intake, hypoxia, pre-mature birth, cyanosis and severe RDS, delivery with cesarian section, neonatal convulsion, jaundice and post-kernicterus complication, and head trauma were significantly associated with increased risk of CP. MRI scan was useful in revealing underlying brain abnormalities and speculating on the etiology of cerebral palsy.