Objective To summarize the MRI findings of extramedullary epidural tumors. Methods Forty-two patients with extramedullary epidural tumors confirmed by surgery and pathology who underwent MRI examination in our hospital were collected. The MRI findings were retrospectively analyzed. Results MRI of metastasis tumors showed long T1 and T2 abnormal signal, high signal on anti-fat sequence, enhanced scan in moderate or obvious enhancement. MRI of Cobb syndrome showed equal signal on T1WI, slightly higher signal on T2WI and obviously high signal on anti-fat T2WI. Enhanced scan showed that there was inhomogeneous enhancement in adnexa, vertebrae and spinal lesions. There were circuitous and flow void vascular shadows. MRI of lymphoma showed equal or low signal and high signal on T2WI. Enhanced scan showed obvious and homogeneous enhancement, with periductal sign; MRI of myeloma showed long T1 and long T2 abnormal signal, high signal on anti-fat T2WI. MRI of osteosarcoma showed inhomogeneous low signal on T1WI and inhomogeneous high signal on T2WI and enhanced scan showed obvious enhancement. MRI of neurogenic tumors showed equal signal on T1WI, slightly higher signal on T2WI, obvious shift of spinal for compression and clear boundaries. MRI of malignant small round cell tumor showed high signal on T1WI, equal spinal cord signal on T2WI, follicular T1 and T2 signal in lesions and enhanced scan showed obvious homogeneous enhancement. Conclusion MRI signal, changes of peripheral soft tissue and enhancement degree of enhanced scan can be used as an important reference for the diagnosis of extramedullary epidural tumors.