Background: During the last few years, the role of magnetic resonance imaging (MRI) as a diagnostic tool in neuroradiology is well–established. There are many kinds of intracranial extra–axial lesions, and definitive diagnosis is complicated in some cases. With advanced MRI techniques such as perfusion, diffusion and spectroscopy, it is now possible to differentiate between these lesions.

Materials and Methods: MRI brain of 140 patients with varying clinical symptoms was performed on 1.5–T MR system using a dedicated head coil.

Purpose: To illustrate imaging features of various intracranial extra–axial lesions using MRI.

Results: A total of 140 patients in a span of 2 years were studied in which majority of the patient’s i.e. 72 % had extra–axial neoplasms. Tumours of the meninges (29%) were the most common extra–axial lesion followed by congenital/developmental cysts (26%). Meningioma (90%) was the most common meningeal tumour while arachnoid cyst (62%) was the most common extra–axial cystic lesion. The most common location of the extra–axial lesion was sellar region. Amongst the lesions of the sellar region, pituitary macroadenoma (50%) was the commonest.

Conclusion: MRI is an excellent modality for classifying and evaluating the different intracranial extra–axial lesions. Recent advanced MRI tests aids in characterization and narrowing the differential diagnosis, for definitive diagnosis, still histologic tissue evaluation is needed for uncommon and tumours with atypical presentation. Thus by providing complete information, MRI helps in better management and prognosis of these patients.