Objective To investigate the diagnostic value of MRI and CT in the patients of vertebral compression fracture complicated with hemorrhage. Methods The clinical data of 32 patients with pathologically confirmed vertebral compression fracture with hemorrhage who were treated in our hospital between January 2009 and 2014 were analyzed retrospectively. The CT and MRI features of all cases were analyzed and compared. The application value of the two diagnostic methods was evaluated. Results Among 32 subjects, there were 28 cases with single vertebral lesions, 3 cases with double vertebral lesions and 1 case with triarticular vertebral lesions, 18 cases with lesions in thoracic vertebra and 14 cases in lumbar vertebrae. MRI findings showed the shapes of vertebral body were as following: wedge-shaped in 16, inverted wedge-shaped in 0 case, concave shape in 14 cases and flat-shaped in 2 cases. There was low signal on T1WI in 10 cases, high signal on T2WI in 8 cases, low signal on DWI in 12 cases, and high signal on DWI in 2 cases. There was trailing edge distension in 3 cases, angulation in 29 cases and pedicle destruction in 0 case, low signal on T1WI in 1 cases, nodular masses in 0 case and ring thickening in 11 cases. CT showed anterior and lateral vertebral margin with lucency transparent lines. There were 17 cases with local cortical bone fracture nonunion, 7 cases with vertebral bilateral alterations and 12 cases with compact vertebral anterior column bone density and disorder. Three cases with traumatic compression fractures were diagnosed by CT. Besides, there was anterior vertebral bone cortex with small cracks, and only 1 case showed local vertebral bone density increasing and vertebral body connection. Conclusion Through the analysis of MRI and CT imaging features of patients with vertebral compression fracture complicated with hemorrhage, it indicates that both of them is of high value in the diagnosis of the disease.