Background: Uterine and adnexal pathologies refer to various conditions and diseases that can affect the uterus and adnexal structures in the female reproductive system. The present study was conducted to evaluate the role of diffusion-weighted imaging and MRI in identifying uterine and adnexal lesions and distinguishing between benign and malignant lesions. Materials & Methods: 85 patients with uterine and adnexal lesions underwent Siemens Avanto Magnetic Resonance Imaging (1.5 Tesla). Results: The age group 20-30 years had 34 patients, 30-40 years had 40 and 40-50 years had 11 patients. The difference was non- significant (P> 0.05).Diffusion restriction was absent in 35 benign uterine and cervical lesions and present in 9 malignant lesions. Diffusion restriction was absent in 21 and present in 14 benign adnexal lesions and present in 6 malignant lesions. The difference was significant (P< 0.05). The sensitivity, specificity, positive predictive, negative predictive value and accuracy of MRI in detecting and differentiating benign and malignant uterine and adnexal lesions was 96%, 100%, 100%, 97.5% and 98% respectively. Conclusion: MRI is anexcellent tool for identifying and describing lesions in the uterus and adnexa. Because many benign adnexal lesions had low ADC values, DWI has a limited role in the case of adnexal lesions.