Back ground: Diagnosing low back pain clinically is difficult in certain situations; in such cases identifying the cause can be done by radiological investigations such as plain radiography, MRI. The main factors responsible for low back ache include degenerative disc disease, infective, congenital, neoplastic and non traumatic spondylolisthesis. Aim: The aim of this study is to study the MODIC changes among patients presenting with low back pain and end plate involvement assessment by MRI and radiography. Materials and Methods: Data from all the patients was collected pertaining to age, sex, socioeconomic status, relevant personal history, family history, history of trauma. These patients were advised to undergo Plain radiography and MRI to identify exact cause of low back ache. Results of MODIC changes, anteroposterior, lateral view radiography findings and MRI end plate changes in sagittal T1W, T2W and STIR sequences was entered into spread excel sheet and evaluated. Results: Out of 120 patients with low back ache, 44 (36.6%) patients were noted with MODIC changes by radiography and MRI. Out of 44 patients with MODIC changes, 17 (38.6%) patients who had type II/III and 12 (27.2%) patients who had type II were observed in majority, followed by 7 (15.9%) patients with type I/II, 6 (13.6%) patients with type III and 2 (4.5%) patients with type I. Conclusion: Now–a–days, most number of patients unable to bear pain anymore, so advancement is going more towards accurate diagnosis and early management. In such cases MRI is an ultimate to diagnose the pathology behind Low Back Pain and Plain radiography is readily available in any nearby accessible health care settings.