This chapter explores the critical role of radiological imaging in the assessment and management of lumbar spine conditions. It outlines the key imaging modalities—plain radiography, computed tomography (CT), magnetic resonance imaging (MRI), and myelography—and highlights their indications, techniques, and interpretations. Plain radiography remains essential for initial evaluations, while CT provides detailed visualization of bony anatomy, particularly valuable in trauma and preoperative planning. MRI is preferred for examining soft tissue structures and assessing conditions like spinal stenosis and disc herniation. The chapter also discusses the utility of advanced imaging techniques, including bone scintigraphy and emerging technologies such as 3D imaging, AI-driven diagnostics, and their potential impact on lumbar spine pathology diagnosis and treatment. Through a comprehensive review of these imaging modalities, this chapter emphasizes the importance of a structured approach to radiological evaluation in optimizing surgical planning and improving patient outcomes.