Objective To observe the characteristics of MRI multiple sequences of thoracic and lumbar tuberculosis and analyze their clinical diagnostic value. Methods A total of 30 cases of thoracic and lumbar tuberculosis patients were scanned by MRI. Results There were 2 vertebral bodies with involvement in 18 cases, accounting for 60.0% and more than 2 vertebral bodies with involvement in 12 cases, accounting for 40.0%. The largest number of vertebral bodies with involvement was 5, a total of 78 vertebral bodies were involved, including 18 thoracic vertebrae, 22 thoracic and lumbar spines, 32 lumbar vertebrae and 6 lumbosacral vertebrae. 78 destructed vertebrae showed more low signal, few low, equal mixed signal on T1WI. T2WI fat suppression sequences showed homogeneous high signal. Area of bone destruction showed inhomogeneous high signal on T2WI, inflammatory edema showed patchy low signal on T1WI. Involved vertebrae of 25 cases were close to 55 intervertebral discs damage, narrowing or disappearance, the intervertebral space was not changed in 5 cases. The involved intervertebral disc showed low signal on T1WI, 35 involved intervertebral discs showed heterogeneous mixed signals on T2WI, and 20 involved intervertebral discs showed inhomogeneous high signal on T2WI. There was cold abscess close to vertebral body in 30 cases, cold abscess mostly occurred in more than 2 vertebral bodies, showing low signal on T1WI in 22 cases, equal signals in 8 cases, showing mixed high signal on T2WI in 8 cases, homogeneous high signal in 20 cases, low signal in 2 cases. In 15 cases, there was spinal stenosis in 30 affected vertebral bodies, of which 4 cases of deformed spinal cords showed abnormal high signal on T2WI. Conclusion MRI can display vertebral body damage, shape and signal changes of intervertebral disc, cold abscess, spinal involvement and other early imaging features of thoracic and lumbar tuberculosis. Multiplanar imaging can show the complete involvement of vertebral body and the number of lesions, and also shows the internal and external spinal epidural lesions and compression of vertebral abscess on the spinal cord.