Vertebral compression fractures may occur due to benign or malignantconditions. This may constitute a diagnostic challenge in elderly populationparticularly with history of primary malignancy. Many radiological techniquesproved its efficacy in differentiation between these lesions including magneticresonance imaging with its new techniques as diffusion, dynamic andinphase/outphase imaging, CT, plain radiography, bone densitometry,scintigraphy and PET. A scoring system based on MR and CT findings wassuggested to improve diagnostic accuracy.