Background: Encephalopathy in pediatric patients encompasses a range of neurological disorders that impact brain function, resulting in symptoms such as developmental delay, seizures, and cognitive impairment. MRI is a crucial diagnostic tool for assessing structural and functional abnormalities in the brain, yet its effectiveness in providing critical diagnostic insights for various forms of encephalopathy in pediatric patients requires evaluation. This study aims to analyze the effectiveness of MRI findings in diagnosing encephalopathies in a pediatric cohort. Materials and Methods: A retrospective analysis was conducted on MRI scans from 100 pediatric patients (age range: 0-18 years) diagnosed with encephalopathy at a tertiary care hospital. MRI findings were categorized into structural abnormalities, diffusion abnormalities, and signal intensity alterations across various brain regions. Patients were grouped according to the type of encephalopathy (hypoxic-ischemic, metabolic, infectious, or idiopathic) to examine the correlation between specific MRI findings and clinical diagnoses. Statistical analysis was performed to determine the sensitivity, specificity, and predictive value of MRI findings for each encephalopathy type. Results: Of the 100 patients, 70% presented with structural abnormalities, primarily in the basal ganglia and cortical regions. Diffusion abnormalities were detected in 55% of cases, notably among patients with hypoxic-ischemic encephalopathy (65%). Signal intensity alterations in the cortical and subcortical areas were observed in 40% of metabolic encephalopathy cases. MRI demonstrated a sensitivity of 85% and specificity of 90% for detecting hypoxic-ischemic encephalopathy, with a positive predictive value of 88%. MRI findings correlated with clinical diagnosis in 80% of metabolic encephalopathy cases but were less definitive in idiopathic cases, where correlation was only 50%. Conclusion: MRI proves to be an effective diagnostic tool for identifying specific patterns of brain abnormalities associated with different types of encephalopathy in pediatric patients. The modality shows high sensitivity and specificity, particularly in hypoxic-ischemic cases, making it a valuable resource for accurate diagnosis and subsequent management. Further studies are recommended to refine MRI criteria for idiopathic encephalopathies and enhance diagnostic accuracy across all encephalopathy types in children.