Magnetic resonance imaging (MRI) is playing an important role in the clinical evaluation of women presenting with urethral symptoms. Voiding cystourethrography, direct urethrography, and pelvic sonography provide limited information on abnormalities that are in continuity with the urethra. On the other hand, urethra and periurethral tissues can be noninvasively evaluated by high-resolution endocavitary MRI. Because of its multiplanar capability and high tissue contrast, endovaginal MRI is an extremely reliable diagnostic test in the evaluation of urethral abnormalities. In this article, the utility of endovaginal MRI in the detection and characterization of a wide spectrum of urethral pathologic conditions, such as congenital anomalies, diverticula, urethritis, and benign and malignant neoplasms, is discussed.