Purpose of Review <p>The purpose of this publication is to review the role of imaging in axial spondyloarthritis. These findings were presented at the SPARTAN annual meeting in May 2024.</p> Recent Findings <p>Imaging plays a major role in the diagnosis and monitoring of axial spondyloarthritis. Magnetic resonance imaging (MRI) findings of active inflammatory lesions (bone marrow edema, capsulitis, inflammation in an erosion cavity, enthesitis, fluid in the joint) and structural lesions (erosions, fat lesions, fat metaplasia in an erosion cavity, bone bud, ankylosis) aid in the early diagnosis of axial spondyloarthritis. Recent data strongly suggests that positive imaging of the sacroiliac joint, especially MRI signs of inflammation, can predict axial spondyloarthritis progression and prognosis. Emerging data supports that MRI findings at baseline might play a role in predicting treatment response.</p> Summary <p>This review covered different imaging concepts, including the role of imaging in early diagnosis as well as prediction of progression, prognosis, and treatment response.</p>