Multiple sclerosis is the most prevalent chronic demyelinating autoimmune disease that affects the central nervous system (CNS). It can be effectively managed with a favorable prognosis when promptly and accurately diagnosed and treated. Among the array of diagnostic tools, magnetic resonance imaging (MRI) stands out as the foremost paraclinical resource, playing a pivotal role in diagnosis, treatment monitoring, and prognosis assessment in multiple sclerosis patients. Proficiency in recognizing the distinctive features of typical multiple sclerosis lesions in the brain and spinal cord necessitates a comprehensive understanding of the underlying pathological factors. This knowledge is fundamental for achieving a precise diagnosis in suspected cases and mitigating the risk of misdiagnosis. This article will review the attributes and characteristics of typical multiple sclerosis lesions and important red flags and delve into the key indicators within imaging.