Objective To investigate the relationship between preoperative magnetic resonance imaging (MRI), computed tomography (CT) and postoperative recurrence in patients with lower extremity giant cell tumor (GCT). Methods The clinical data of 44 patients with lower extremity GCT admitted from 2006 to May 2016 were analyzed retrospectively. The imaging findings of GCT were compared between CT and MRI. The patients were divided into recurrence group (n=13) and non-recurrence group (n=31) according to whether the recurrence occurred after operation or not. The relationship between preoperative imaging findings and postoperative recurrence was analyzed. Results In the CT and MRI imaging findings, there was no significant difference in tumor volume between the two groups (P>0.05). In the CT imaging finding, there was no significant difference in the incidence rates of crest bone destruction and cortical destruction between the two groups (P>0.05). In MRI imaging findings, there was no significant difference in the incidence rates of cystic changes, peripheral tissue hematoma, soft tissue invasion, and incomplete low hoop of lesion edge between recurrence group and non-recurrence group (P>0.05). The incidence rate of necrotic hemorrhage in recurrence group was higher than that in non-recurrence group (P<0.05). Conclusion Preoperative MRI helps to provide information for judging the recurrence of GCT.