No previous studies discussed the significance of the MRI pattern of vertebral collapse in differentiation between vertebral compression fractures due to malignancy, osteoporosis and infections. MRI was used in evaluation of 152 atraumatic vertebral compression fractures in 80 patients: 85 metastatic, 34 osteoporotic and 33 infective. Central collapse of the fractured vertebral body was the most common pattern in malignant fractures (57 vertebrae, 67 %), followed by uniform collapse (21 vertebrae, 24.7 %), then anterior wedging (5 vertebrae, 5.9%) and lastly posterior wedging (2 vertebrae, 2.4 %). In osteoporotic fractures, anterior wedging was the most common pattern (18 vertebrae, 53 %), followed by central collapse (11 vertebrae, 32.3 %), then uniform collapse (4 vertebrae, 11.8 %), and lastly posterior wedging (1 vertebra, 2.9 %). In vertebral compression fractures due to spinal infection, anterior wedging was the most common pattern (20 vertebrae, 60.6 %), followed by uniform collapse(12 vertebrae, 36.4 %), while only one vertebra (3 %) was centrally collapsed. Central collapse of vertebral body is highly suggestive of malignant compression fracture while anterior vertebral wedging is very highly suggestive of a benign compression fracture.