This article summarizes the evidence behind the imaging evaluation of scoliosis, which is primarily performed with plain radiographs and MR imaging. Issues related to the radiographic evaluation of spinal curvature include interobserver variability of scoliosis measurements and the radiologist's detection of unexpected findings. The effects of radiation exposure during scoliosis evaluation and strategies to minimize radiation dose are summarized. The use of MR imaging in idiopathic scoliosis is discussed, with special attention to imaging groups at higher risk for underlying pathology of the neural axis.