Craniovertebral junction (CVJ) abnormalities constitute an important group of treatable neurological disorders caused by various etiologies like congenital, developmental, infective, inflammatory, neoplastic and traumatic. Their precise diagnosis, identification of probable etiology, and pretreatment evaluation significantly affects prognosis and quality of life of patients. MRI has more recently come into play to assess the ligaments, brainstem and spinal cord at the CVJ. This prospective study was conducted on 50 patients to classify various CVJ disorders according to their etiology and to define the importance of precise diagnosis for pretreatment evaluation using MDCT and MRI. Male to female ratio was 1.9:1 (33 males and 17 females) and the most common age group was >50 years. Multiplanar MRI was of great value in identifying the CVJ abnormalities precisely except for trauma where CT was accurate. Commonest CVJ abnormality was developmental anomaly 62% (n=31) followed by trauma 18% (n=9), arthritis 8% (n=4), infective 6% (n=3) and neoplastic 6% (n=3). Developmental anomaly was basilar invagination 45.1% (n=31) out of which BI–II (64.2%) was more common than BI–I (35.7%). Commonest finding on CT and/or MRI was cord compression followed by atlantoaxial dislocation in patients with anomaly