Stress-related bone injuries are common in professional athletes and in military personnel. However, in an increasingly health conscious society undertaking more, and often unsupervised, exercise regimes, these injuries may increase. Early diagnosis is of paramount importance to detect the signs of stress reaction, allow heating, and prevent progression to frank fracture. This review illustrates the classical magnetic resonance imaging (MRI) features of stress injury and fracture with emphasis on its role in the diagnosis and follow-up, as well as its limitations. (c) 2007 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.