Objective: This study aims to evaluate the diagnostic efficacy of Magnetic Resonance Imaging (MRI) in assessing scrotal lesions, with a focus on differentiating between benign and malignant conditions. The limitations of ultrasound in some scrotal pathologies underscore the need for an advanced modality like MRI to improve diagnostic accuracy.Methods: A prospective cross-sectional study was conducted on 102 male patients presenting with symptoms of scrotal lesions. All participants underwent both ultrasound and MRI evaluations, with results compared against histopathological findings. Imaging sequences included T1-weighted, T2-weighted, and diffusion-weighted imaging (DWI). Statistical analyses included sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and ROC curves to assess MRI's diagnostic accuracy.Results: MRI showed higher diagnostic accuracy (96.1%) compared to ultrasound (91.2%) in identifying scrotal lesions. Specifically, MRI demonstrated sensitivity and specificity rates of 94.1% and 96.5%, respectively, while ultrasound showed 88.2% and 91.8%. ROC analysis further established MRI’s superior diagnostic performance in distinguishing between torsion, epididymo-orchitis, and malignancies.Conclusion: MRI is a valuable diagnostic tool for scrotal lesions, particularly in cases where ultrasound results are inconclusive. Its high sensitivity and specificity make MRI a recommended modality for comprehensive scrotal lesion evaluation