Objective To investigate the MRI manifestation of lesions in knee joint, and to compare the sensitivity of detection between the MRI and knee joint endoscopy. Methods 34 cases were analyzed retrospectively, MRI and knee joint endoscopy were performed on all the 34 patients. Result 27 meniscus degeneration and tear, 22 interosseous ligaments of knee tear, 3 ligaments collaterale tear, 2 chondroid degeneration or necrosis, and 30 hydrarthrosis were detected by MRI;25 meniscus degeneration and tear,17 interosseous ligaments of knee tear, 14 chondroid degeneration or necrosis, and 10 synovial hyperplasion were detected by endoscopy. Conclusion ① MRI was a most important tool for detecting knee joint lesions. ② MRI is more effective to demonstrate the hydrarthrosis, meniscus degeneration and tear, ligaments collaterale tear compared to endoscopy. ③there are false diagnosis in MRI and knee joint endoscopy.