The use of magnetic resonance (MR) imaging for evaluating the abdomen and pelvis has been limited by the lack of a suitable contrast agent. The purpose of this study was to compare axial MR imaging after rectal barium administration with computed tomography (CT) for delineation of normal anatomy and lesions of the pelvis. MR images and CT scans of 11 patients were studied retrospectively and independently by four radiologists. No substantial differences in the visualization of normal bowel, iliac vessels, lymph nodes, bladder, prostate, seminal vesicles, uterus, and cervix and in detection of abnormalities were seen between CT scans and axial MR images obtained after barium administration. This preliminary study suggests that axial MR imaging with rectal barium is a useful alternative to CT in evaluating pelvic disease.