Objective To analyze MSCT and MRI findings of thoracic extramedullary hematopoiesis (TEMH) and myelolipoma (ML). Methods Imaging data of 10 cases with TEMH and 4 cases with ML diagnosed by pathology in the hospital from January 2010 to July 2017 were retrospectively analyzed. MSCT and MRI findings of TEMH and ML were identified. Results Both of MSCT and MRI could clearly display lesions. There were mediastinal extramedullary hematopoiesis tissue tumor-like hyperplasia and ML. In 14 cases, there were 18 posterior mediastinal tumor-like hyperplasia and 4 myeloid myelolipomas. The imaging data showed soft tissue masses beside the posterior mediastinal spine, and masses were connected with the spinal wide base. 42 lesion of T2~T12 vertebral bodies were detected. 10 cases of TEMH were posterior mediastinal multiple masses, while 4 cases of ML included 2 cases of single solitary soft tissue mass and 2 cases of bilateral symmetrical masses. MSCT of 4 cases of TEMH showed homogeneous and equal density and moderate enhancement. MRI showed equal signal on T1WI and T2WI and enhanced scan showed homogeneous enhancement, multiple foci located in the paraspinal region. 6 cases of TEMM showed inhomogeneous and equal-low mixed density. Enhanced scan showed partial soft tissue slightly enhanced. MRI showed equal-low mixed density on T1WI and T2WI, with inhomogeneous enhancement and multiple lesions in the paraspinal region. 4 cases of ML showed inhomogeneous and equal- low density, with inhomogeneous enhancement. T1WI scan showed soft tissue low signal while adipose tissue showed medium high signal. T2WI scan showed no enhancement in adipose tissue, and there only was soft tissue enhancement. Conclusion MSCT and MRI data can provide imaging basis for the clinical diagnosis and identification of TEMH and ML.