Epilepsy surgery is a neurosurgical procedure in which a cerebral area identified as being epileptogenic is removed or disconnected. In recent years, the quality of MRIs has increased along with its success in detecting the so-called “epileptogenic lesion”. The location of the lesion and its nature once identified as possibly being epileptogenic, provide decisive information concerning the risk and difficulty of the proposed epilepsy surgical procedure, thus enabling an early treatment option for the patient. This chapter explores when to use MR imaging and where to perform it, general MRI protocol, specific MRI protocols, such as diffusion-based imaging and MR spectroscopy. It presents typical features of pathologies that are commonly associated with epilepsy. These are divided into easy, moderately difficult, very difficult, palliative and non-surgical candidates. The chapter also presents an overview of the most common epileptogenic lesions and their respective MRI criteria.