Objective To study the magnetic resonance imaging(MRI) features of adult ovarian granulose cell tumor and pathology correlation. Methods The clinical and MRI data of 40 patients with adult ovarian granulose cell tumor confirmed histologically were analyzed retrospectively. Results 40 cases showed single lesion which appeared as a cystic, solid or solid cystic mass with sharp margin within uterine attachment region on MRI plain scan. 23 cases had multilocular solid cystic masses, which showed low mixed signal areas in T1WI and high ones in T2WI, and had different sizes and a smooth inner wall without clear tubercles. 11 cases were a single loculus or multiple loculi cystic masses with 8cm or greater in diameter, within which smooth inner wall could be seen. MRI showed uniform low signal areas in T1WI and uniform high ones in T2WI. 6 cases were solid masses of about 3-5cm in size, which displayed a signal that equate to the same level muscle signal in T1WI and way above muscle signal in T2WI. On enhanced MRI scan, lesions of 40 cases demonstrated solidl enhancement or septal enhancement without cystic enhancement. Twenty-seven cases with ascites, there are no correlation about the Ascites levels to tumor size (r=0.19, P=0.08). Conclusion The typical MR imaging features were as follows: 1. loculi solid cystic mass within uterine attachment region with smooth inner wall and without clear tubercles. 2. Cystic or solid mass with sharp margin, uniform signal and pseudocapsule.MRI imaging of adult ovarian granulose cell tumor was consistent with pathologic assessment.