Background: Acute knee injuries are a common source of morbidity in athletes and if overlooked may result in chronic functional impairment. This study aimed to identify imaging pattern in bone bruises / bone marrow edema and to correlate the pattern of bone marrow edema with the intra- (anterior and posterior cruciate ligaments as well as medial and lateral meniscal) and extra-articular (medial and lateral collateral ligaments) injuries. Methods: This was retrospective cross-sectional study was carried out on 109 patients who presented to the radiology department "Saudi-German hospital Aseer" with history of recent knee joint injury and requested for MRI Knee joint, during the period from January 2017 to January 2019. Results: The mean age of all studied patients was 30.2 ± 9.7 years with minimum age of 12 years and maximum age of 55 years. As regard sex, there were 90 males (82.6%) and 19 females (17.4%) in the studied patients. Regarding bone marrow (BM) contusion patterns in all studied patients. It was pivot shift in 58 patients (53.2%), clip injury in 11 patients (10.1%), dashboard injury in 7 patients (6.4%), hyperextension injury in 3 patients (2.8%), lateral patellar dislocation in 15 patients (13.8%) and others in 15 patients (13.8%). Conclusion: MRI is the gold standard in diagnosing bone marrow contusion. Precise location of contusion and its pattern on MRI, allows focused search for associated soft tissue injury; ligamentous and meniscal tear which may create better patient management outcomes.