Objective To analyze the clinical value of MRI in differential diagnosis of early spondylitis. Methods 75 cases of patients with spondylitis in our hospital from March 2015 to March 2018 were selected. According to the diagnostic criteria, they were divided into suppurative spondylitis group, Brucella spondylitis group and tuberculous spondylitis group. The three groups were confirmed to have spondylitis by surgical pathology or clinical follow-up, and they were examined by MRI. The changes of lesions sites and MRI signs were observed among the three groups. Results The lesions in suppurative spondylitis group were concentrated in the lumbar vertebrae (68.00%), and the lesions in Brucella spondylitis group were concentrated in the lumbar vertebrae (76.00%), and the lesions in tuberculous spondylitis group were concentrated in the thoracic vertebrae (60.00%), and there were significant differences in the lesions sites among the three groups (P<0.05). There were no significant differences in MRI signs of T1WI low signal, T2WI high signal, epidural abscess and vertebral body involvement among the three groups (P>0.05). There were statistically significant differences among three groups in the MRI signs of abnormal signals of intervertebral disc, vertebral lesions, lesions morphological changes, abnormal signals of paravertebral soft tissues and intraosseous or paravertebral abscess (P<0.05). Conclusion There are some differences in MRI signals and signs among suppurative spondylitis, Brucella spondylitis and tuberculous spondylitis. They can combine with clinical diagnosis results to provide a reference for the differential diagnosis of patients with early spondylitis.