Objective To compare and analyze the diagnostic value of CT discography and MRI in discogenic low back pain. Methods 50 cases of patients with suspected discogenic low back pain treated in hospital from January 2014 to June 2015 were selected as the research objects. MRI, CT plain scan and CT discography (CTD) were performed. The diagnostic results of MRI and CT discography in the diagnosis of Modic signs, changes of HIZ and fibrous ring rupture typing were compared. Results There were 80 CT discography. CTD typing: 34 type I, 22 type II, 14 type III and 10 type IV. There were 31 concordant pain (38.7%). 15 patients with HIZ and 64 without HIZ were on MRI and the sensitivity and specificity of HIZ in predicting pain were 29.0% and 87.8%, respectively. CTD showed a total of 12 lumbar intervertebral disc of Modic signs, of which 11 were concordant pain and 1 case was not concordant pain or different. There were 32 grade IV~V lumbar intervertebral disc degeneration on MRI, of which 26 were CTD concordant pain (81.3%). The rate of grade IV~V degeneration concordant pain on MRI was significantly higher than that of patients with grade I ~ III degeneration (P < 0.01). Conclusion CT discography can clearly show discogenic low back pain with fibrous ring rupture. The typical imaging features of MRI are HIZ and grade IV~V lumbar intervertebral disc degeneration. Prediction of the relationship between concordant pain and CTD typing is helpful for the further determination of MRI of intervertebral disc.