Technological advances in the area of magnetic resonance imaging (MRI) raised expectations on the potential role of this imaging modality for evaluation of the gastrointestinal tract, especially on Crohn's disease (CD), based on the high spatial and tissue resolution as well as lack of ionizing radiation. Available evidence indicates that MRI has a high diagnostic accuracy for the detection of disease activity, location of the lesions, and also for determining the severity of the disease, which together are the main aspects for the therapeutic decision-making in patients with CD. MRI provides a high accuracy in detection of strictures, characterization of fistulizing lesions and extraluminal complications such us abscesses which are a key finding for considering medical and surgical options. Knowledge of the pathological substrate of inflammatory lesions in CD as well as extraenteric lesions may improve diagnostic image interpretation, and thus contribute to optimize patient care.