Back pain is a common complaint in patients with cancer. The standard diagnostic approach includes plain roentgenograms and radionuclide scans. We report two patients who presented with back pain and had unremarkable or equivocal roentgenograms and radionuclide scans. Their MRI scans demonstrated metastatic disease to the bone and spinal cord compression. The role is discussed of MRI scanning in patients with solid tumors and persistent back pain.