Ultrasound of neuraxis can be used to identify the best possible inter-spinous space to perform neuraxial block.The aim of this study was to assess the anatomical correlation between neuraxial ultrasound and magnetic resonance imaging(MRI). Twenty-one patients who underwent MRI of the lumbar spine had ultrasound of lumbarneuraxis performed by an experienced operator. Each lumbar interspinous space was graded on ultrasound as good [posteriorcomplex (ligamentum flavum and duramater) and anterior complex (posterior longitudinal ligament) visible], intermediate (eitheranterior complex or posterior complex visible) or poor (both anterior complex and posterior complex not visible) in boththe transverse median (TM) and paramedian sagittal oblique (PSO) plane. Pre-determined MRI parameters were measuredby a radiologist blinded to sonographic findings at each inter-spinal level. Seventy-eight lumbar interspinous spaceswere evaluated. There was a significant association (p<0.004) between the facet joint degeneration on MRI and the poor ultrasoundview in the transverse median (TM) group. The odds of obtaining a poor view in TM plane was 7 times higher (95% CI1.7-28.9, p=0.007) in the presence of facet joint degeneration. None of the other variables had a significant association with a poor neuraxial view in the TM plane. Poor views in the parasagittal oblique (PSO) plane did not correlate with any of thevariables measured on MRI. Facet joint degeneration is a major contributing factor to poor neuraxial ultrasoundviews in the TM plane.