Objective To study the MRI features of hand, foot and mouth disease encephalitis, in order to improve the understanding of MRI manifestation of the disease, the clinical judgment condition and provide reliable imaging based on treatment outcome. Methods One hundredand twenty-seven to our hospital in dongguan area of children with hand, foot and mouth disease encephalitis in craniocerebral MRI scanning, capture and analysis T1WI, T2WI, T2WI/FLAIR and DWI images, can the pathological changes of signal and location, shape and surrounding edema of analysis. Results One hundredand twenty-seven of cerebral MRI scans in 109 (86%) cases of abnormal parenchymal did not see clear signal, 18 (14%) cases of abnormal signal has a performance: spots, patchy slightly low or iso signal, belt-like T1WI, T2WI is slightly high or iso signal, T2WI/FLAIR show high signal, contrasts than T2WI, lesions showed more clear, DWI is iso or high signal, such as most of the lesions, fuzzy boundaries considering for acute stage performance, peripheral edema is not obvious, did not see clearly to take effect, only part of the brain stem with enlargement, ventricle slightly narrowed, including 13 cases of male, female in 5 cases (male to female ratio is about 2.6:1), 10 cases of lesions located in the brain stem, deep lesions involving the nucleus accumbens, on both sides of the half egg circle center and the frontal, parietal area 8 cases of cerebral white matter, is located in the cerebellum in 1 case. Conclusion Hand, foot and mouth disease often single or multiple involving the brain stem encephalitis, signal with low contrast, peripheral edema is not obvious, MRI performance has a certain characteristic; T2WI, T2WI/FLAIR and DWI sequence contrast is relatively high, the lesion detection, scope, judgment plays an important role. MRI in the diagnosis of hand, foot and mouth disease encephalitis, has the obvious advantage in the prognosis, which has important reference meaning.