Endocrine disorders of the hypothalamus and pituitary gland are often caused by lesions which can be accurately detected and delineated by MRI, often with specific findings. MRI has emerged as the imaging modality of choice for pathology of the hypothalamus and other suprasellar structures, and for extrasellar extension of pituitary tumours. The advantage is mainly based on the high contrast resolution, vascular visualization without the need for intravascular contrast and direct multiplanar imaging capability inherent with the technique. CT, however, enjoys much wider availability and better spatial resolution at present. CT is still the method used to detect pituitary microadenomas in most centres, although high field-strength MR scanners and gadolinium enhancement permit thinner sections with improved sensitivity in certain institutes. Further advances in MRI technology are expected to broaden its usefulness in endocrinology.