Objective To study the clinical effect of MRI and CT in diagnosis of tibial plateau fractures. Methods 105 cases of patients with tibial plateau fractures in the hospital were selected as the research object. All of the subjects received MRI and CT examination. The examination results were compared with the results of surgical and pathological diagnosis to analyze the features of MRI and CT for patients with tibial plateau fractures. Results The differences in the display results of the two kinds of detection methods for comminuted fracture, displacement fracture, bone defect, fracture sites were not statistically significant (P>0.05); surgical pathology confirmed that there were 27 cases of type B1, 20 cases of type B2, 11 cases of type B3, 28 cases of type C1, 11 cases of type C2 and 8 cases of type C3. The diagnose accordance rates of CT diagnosis respectively were 88.89%, 95%, 100.00%, 82.14%, 90.91% and 87.50%. There was no significant difference, compared with 100.00%, 100.00%, 100.00%, 92.86%, 100.00% and 100.00% (P>0.05)but the diagnose accordance rates of MRI diagnosis for parts of the bone types was too high; the accuracy of CT in diagnosis of fracture and classification of types were 93.33% and 90.48% which were relatively lower than 98.10% and 97.14% of MRI diagnosis. The coincidence rate of classification of types was statistically significant (P<0.05). Conclusion MRI and CT were effective ways for diagnosis of tibial plateau fractures, while between the two, the value of MRI was higher.