Spasticity, a component of the pyramidal syndrome, characterized by increased tonic stretch reflexes and hyperactive deep tendon reflexes, occurs in patients with central nervous system lesions (stroke, brain or cord injury, multiple sclerosis, cerebral motor impairment). The implementation of standard procedures (patient positioning, increased examination time, turning off certain devices before MR imaging) allows the acquisition of high quality examinations in spastic patients. Worsening spasticity in a handicaped patients is due to an irritative process (deep seated infection, fracture, syrinx...) usually detectable with imaging. Ultrasound or CT guided injections of botulinum agents provides radiologists with the opportunity to further participate in the management of spastic patients.