Background: Sciatic nerve injuries and diseases may cause severe pain and disability. Management and therapy of these disorders need accurate diagnosis and assessment. Magnetic resonance imaging (MRI) can provide important information about the cause of sciatic nerve problem whether herniated or degenerative disc or other conditions, and it can determine the best course of treatment whether surgery of physical therapy or other non-surgical treatment. This study aimed to compare ultrasound and MRI sciatic nerve diagnosis accuracy and reliability. Methods: This cross-sectional research comprised 45 sciatic nerve-symptomatic individuals. All patients received extensive history gathering, physical examination, clinical assessment using visual analogue scale and Oswestry disability index to assess pain severity and functional impairment, ultrasonography, and MRI.. Results: There was statistically significant difference between ultrasound findings and MRI findings on sciatic nerve tumour, neurofibromas, piriformis syndrome, and injection injury (p=0.001–0.004). Overall sciatic nerve issues were more common in MRI (42 patients, 93.33%) than ultrasound (37 patients, 82.22%), p=0.03). Conclusion: MRI indicated a greater prevalence of sciatic nerve issues than ultrasound, and US and MRI differed in diagnosis.