Thoracolumbar fractures are more common in patients with high-energy spinal trauma, and spinal cord injury can occur in more than 50% of cases. Therefore, early evaluation of thoracolumbar fractures is important, as delayed diagnosis may lead to neurological complications. The clinical evaluation of patients with thoracolumbar fractures is difficult, so imaging takes a central role in their diagnosis. The purpose of this article is to provide a preliminary exploration of the following questions: What are the options for imaging? Which patients should undergo imaging examinations? How should they be examined? What are the common imaging presentations of thoracolumbar spine fractures? The common cause of thoracolumbar fractures is high-energy trauma, such as car accidents or high falls. 4-5% of cases accepted by Level 1 trauma centers are thoracolumbar fractures, and up to 50% of these patients have spinal cord injuries. Therefore, early evaluation of thoracolumbar fractures is important, as delayed diagnosis may lead to neurological complications. Clinical evaluation is often difficult when the patient is unconscious or has an accompanying injury at another site. The probability of delayed diagnosis has been reported to be as high as 20%, often due to failure to perform the necessary imaging studies.