ABSTRACT Objective: to assess Magnetic Resonance Images (MRI) findings in patients with knee osteoarthritis (OA) and to determine whether these findings arecorrelated with various demographic, clinical and radiographic variables. Methods: Twenty patients with previously defined clinical symptoms and radiological signs of knee OA (Group I) and 20 patients with clinically suspected knee OA without typical radiographic signs (Group II) were included. Knee pain, stiffness and physical function were assessed using the Western Ontario and McMaster University (WOMAC)osteoarthritis index. Radiographic severity during standing was measured by the Kellgren and Lawrence (KL) scale. MRI assessment and analysis were done for cartilage lesions, bone marrow edema (BME) pattern, joint effusion, synovial thickeningand meniscal lesions. Results:Group I patients had significantly higher WOMAC score (P=0.000), articular cartilage volume loss (p=0.03) and more meniscal lesions (p=0.01).WOMAC score significantly increased among patients with more articular cartilage defect (p=0.034, p=0.005), larger joint effusion (p=0.034, p=0.044) and thicker synovial membrane (p=0.030, p=0.048)in group I and group II respectively, and with meniscal lesions (p=0.004)only ingroup I. KL score was significantly associated with of MRI findingsof articular cartilage volume loss (p=0.043), BME pattern (p=0.044) ,joint effusion amount (p=0.006) and synovial thickening (p=0.042) in group I patients. Conclusion: MRI can be areliable method in the assessment of structural changes at early stages as well as established knee OA. Articular cartilage defects, joint effusion and synovial thickening signal significantly higher WOMAC and KL scores in both early and established knee OA while, BME pattern only associates higher KL score in established knee OA.