Abstract: Objective: To explore the diagnostic value of MRI for benign and malignant gestational trophoblastic disease. Methods: retrospective analysis of 55 cases (15 benign, 40 malignant) confirmed the MRI manifestations of GTD by clinical operation and pathology.Results: 15 cases of benign lesions were all located in the uterine cavity, and the myometrium was not affected; 40 cases of malignant lesions were located in the uterine cavity in 26 cases, and in 2 cases of the cervical canal, all with myometrial infiltration; 12 cases were located in the myometrium, and the uterine junction zone was continuous. MRI showed that the lesion showed mixed signal shadow, 3 cases of benign and 20 malignant cases were mixed with high signal on T₁WI; After the enhanced scan, 10 of the 40 malignant lesions showed arterial enhancement, 15 cases of lesion separation and solid part were moderately enhanced, 15 cases of cystic lesions showed "blizzard"-like enhancement in the center. The benign ones are separated and gradually strengthened continuously. In 31 cases of malignant lesions, there were more thick and tortuous vascular shadows around the muscle layer and uterus. 5 cases of benign lesions with increased vascular shadows around the palace. Conclusion: The MRI manifestations of benign and malignant GTD have certain characteristics, which can well show the extent of tumor invasion, and help prompt benign and malignant early, and provide basis for clinical diagnosis and treatment.