Objective To summarize the clinical characteristics of cerebellar vermis parasites and to analyze the main MRI findings of the disease. Methods Fourty-six cases of patients with cerebellar vermis parasites who were admitted in our hospital from January 2011 to August 2015 were selected as the study object. Patients' age and clinical symptoms, etc. were analyzed. Head MRI examination was performed. The MRI findings of cerebellar vermis parasites of different stages were analyzed. Results Clinical characteristics: the bad eating habits, the incidence rate of male patients was higher than that of female ones, young adults were high-risk age group and epilepsy was the first symptom. MRI findings were scattered in a single parasite, with presence of small lesions, large number and wide distribution. 76.2% (35/46) were multiple lesions. There were 24 cases (52.2%) in coexistence phase, 9 cases (19.6%) in degeneration and death phase and 13 cases (28.32%) in calcification phase. MRI findings: (1)there was single round or oval shaped low-density lesion shown in coexistence phase. Cystic wall and scolex were not enhanced. There was presence of punctiform scolex in sac. The lesion show mainly low signal on T1WI but high signal of punctiform scolex. The lesion show mainly high signal on T2WI but low signal of punctiform scolex. (2)The body of parasites was enlarged in degeneration and death phase irregularly. On T1WI, it showed irregular ring or nodular high signal on parasite wall and low signal in body of parasites and surrounding edema area; On T2WI, it showed high signal in body of parasites and surrounding edema area and irregular ring or nodular low signal on parasite wall, forming specific changes of parasitic disease: target type lesions. The enhancement of lesions was significant, with nodular or irregular ring enhancement. (3)There was no signal or single or multiple punctiform low signal in calcification phase, without edema area and changes of enhancement. Conclusion The clinical characteristics and MRI findings of cerebellar vermis parasites are characteristic. The combination of the two can make accurate diagnosis.