This study systematically reviewed the published data regarding the sensitivity of magnetic resonance imaging (MRI) compared with bone marrow biopsy as reference standard for the detection of bone marrow involvement in patients with malignant lymphoma. A systematic search for relevant studies was performed of the PubMed/MEDLINE and Embase databases. Two reviewers independently assessed the methodological quality of each study and the sensitivity of the included studies was calculated. The 11 included studies had moderate methodological quality. Sensitivity of MRI for the detection of bone marrow involvement ranged from 50% to 100%, with a median of 100%. MRI is probably sufficiently sensitive to rule out bone marrow involvement in patients with malignant lymphoma. However, a well-designed study with a large sample size is needed to confirm current results.